Individual
MYTHILI KANTHI GUDIPATI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
81 BALL PARK RD, HARLAN, KY 40831-1701
(606) 573-8100
Mailing address
490 WOODLAND HLS, HARLAN, KY 40831-2565
(989) 327-2498
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
58819
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/28/2020
Last updated
01/04/2024
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