Organization
CAROLINA NEUROLOGY ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VENUGOPAL GADIPUDI MD (OWNER)
(910) 484-0029
Entity
Organization
Contact information
Practice address
2500 VILLAGE DR, SUITE 102, FAYETTEVILLE, NC 28304-3811
(910) 484-0029
Mailing address
PO BOX 1689, ETOWAH, NC 28729-1689
(828) 891-5524
(828) 891-4069
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1375A
BLUE CROSS BLUE SHIELD
—
05
—
891375A
—
NC
01
—
DE2869
RAILROAD MEDICARE
—
Enumeration date
08/30/2006
Last updated
12/17/2010
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