Provider Demographics
NPI:1083305957
Name:DOPPALAPUDI, PRAGNA CHOUDARY
Entity Type:Individual
Prefix:
First Name:PRAGNA
Middle Name:CHOUDARY
Last Name:DOPPALAPUDI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HURLEY MEDICAL CENTER, 1 HURLEY PLAZA
Mailing Address - Street 2:GME OFFICE 10W
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503
Mailing Address - Country:US
Mailing Address - Phone:810-262-9000
Mailing Address - Fax:
Practice Address - Street 1:1 HURLEY PLAZA
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-5902
Practice Address - Country:US
Practice Address - Phone:810-262-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2024-01-22
Deactivation Date:2023-12-21
Deactivation Code:
Reactivation Date:2024-01-12
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program