Individual
DR. SHAILAJA DEVI KOPPOLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1850 N CENTRAL AVE, SUITE 1600, PHOENIX, AZ 85004-4633
(602) 744-4765
(602) 744-4799
Mailing address
1850 N CENTRAL AVE, SUITE 1600, PHOENIX, AZ 85004-4633
(602) 744-4765
(602) 744-4799
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
222589
MA
207L00000X
Anesthesiology Physician
Primary
38119
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
355985
—
AZ
Enumeration date
11/23/2006
Last updated
10/14/2010
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