Provider Demographics
NPI:1467641084
Name:VADLAKONDA, NIRUPAMA DEVI (MD)
Entity Type:Individual
Prefix:DR
First Name:NIRUPAMA
Middle Name:DEVI
Last Name:VADLAKONDA
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 1:12201 PLUM ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7803
Mailing Address - Country:US
Mailing Address - Phone:301-572-1000
Mailing Address - Fax:301-572-3302
Practice Address - Street 1:12201 PLUM ORCHARD DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7803
Practice Address - Country:US
Practice Address - Phone:301-572-1000
Practice Address - Fax:301-572-3302
Is Sole Proprietor?:No
Enumeration Date:2007-10-19
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD64583207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD580223700Medicaid
MD217755Y1PMedicare PIN