Individual
RAJA IDUPULAPATI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
47 EXECUTIVE DR, SHELBURNE, VT 05482-7142
(802) 985-0008
(802) 985-0011
Mailing address
388 SHELBURNE RD, APT 102, BURLINGTON, VT 05401-6946
(802) 985-0008
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
033.0003804
VT
Other
Enumeration date
07/08/2016
Last updated
07/08/2016
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