Provider Demographics
NPI:1588829188
Name:GADUPUTI, VINAYA VITTAL (MD)
Entity type:Individual
Prefix:
First Name:VINAYA
Middle Name:VITTAL
Last Name:GADUPUTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-222-7600
Mailing Address - Fax:515-222-7601
Practice Address - Street 1:1601 NW 114TH ST STE 342
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-7036
Practice Address - Country:US
Practice Address - Phone:515-222-7600
Practice Address - Fax:515-222-7601
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MEMD22816207RG0100X
IAMD-46821207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology