Organization
VALEANT MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHANI MOHAN VUPADHYAYULA MD (MEMBER)
(704) 813-7476
Entity
Organization
Contact information
Practice address
1795 DR FRANK GASTON BLVD, ROCK HILL, SC 29732-1190
(803) 326-3500
(893) 336-3632
Mailing address
1121 BALTUSROL LN, WAXHAW, NC 28173-9031
(704) 813-7476
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
11/04/2022
Last updated
08/29/2024
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