Individual
INDIRA DORIS KONANUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
28 STATE ST, SUITE 2850, BOSTON, MA 02109-1775
(617) 903-5009
(617) 903-5009
Mailing address
PO BOX 779, SAN FRANCISCO, CA 94104-7001
(415) 658-6791
(415) 520-0904
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
14926
NH
207R00000X
Internal Medicine Physician
Primary
243668
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30228286
—
NH
Enumeration date
07/10/2007
Last updated
09/06/2012
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