Provider Demographics
NPI:1417000456
Name:KADUMPALLI, KAVITHA SRAVANTHI R (MD)
Entity Type:Individual
Prefix:DR
First Name:KAVITHA SRAVANTHI
Middle Name:R
Last Name:KADUMPALLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 BLUE RIDGE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607
Mailing Address - Country:US
Mailing Address - Phone:919-784-5650
Mailing Address - Fax:919-784-5651
Practice Address - Street 1:2800 BLUE RIDGE ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607
Practice Address - Country:US
Practice Address - Phone:919-784-5650
Practice Address - Fax:919-784-5651
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA220984207R00000X
NC2010-01481207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine