Provider Demographics
NPI:1417342221
Name:KALIDINDI, PRIYANKA (MBBS)
Entity Type:Individual
Prefix:DR
First Name:PRIYANKA
Middle Name:
Last Name:KALIDINDI
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4728 OAK ST
Mailing Address - Street 2:APT 1145
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-2271
Mailing Address - Country:US
Mailing Address - Phone:630-903-1360
Mailing Address - Fax:
Practice Address - Street 1:1043 STERLING RD STE 104
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-3842
Practice Address - Country:US
Practice Address - Phone:703-689-0111
Practice Address - Fax:703-689-0077
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0101265476207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program