Individual
DR. UDAY DANDAMUDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9320 STATE ROAD 54, TRINITY, FL 34655-1808
(727) 493-2513
(877) 917-2336
Mailing address
PO BOX 102222, ATTN CREDENTIALING, ATLANTA, GA 30368-2222
(239) 274-8200
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
ME113142
FL
207RX0202X
Medical Oncology Physician
Primary
ME113142
FL
207ZP0104X
Chemical Pathology Physician
ME113142
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005844600
—
FL
Enumeration date
05/22/2006
Last updated
08/02/2022
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