Provider Demographics
NPI:1588672190
Name:DUGGIRALA, AMAR VENKAT (DO)
Entity Type:Individual
Prefix:DR
First Name:AMAR
Middle Name:VENKAT
Last Name:DUGGIRALA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:19710 FISHER AVE
Mailing Address - Street 2:SUITE J
Mailing Address - City:POOLESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20837-2098
Mailing Address - Country:US
Mailing Address - Phone:301-972-7600
Mailing Address - Fax:301-972-8006
Practice Address - Street 1:19710 FISHER AVE
Practice Address - Street 2:SUITE J
Practice Address - City:POOLESVILLE
Practice Address - State:MD
Practice Address - Zip Code:20837-2098
Practice Address - Country:US
Practice Address - Phone:301-972-7600
Practice Address - Fax:301-972-8006
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDH61505207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine