Individual
DIVYA KONDAMAREDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2001 VAIL AVE, CHARLOTTE, NC 28207-1248
(704) 304-6070
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2014-01441
NC
208M00000X
Hospitalist Physician
2014-01441
NC
Other
Enumeration date
01/10/2012
Last updated
07/15/2024
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