Provider Demographics
NPI:1629371554
Name:GULLAPALLI, RAMACHANDRA RAO (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:RAMACHANDRA
Middle Name:RAO
Last Name:GULLAPALLI
Suffix:
Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:MSC08 4640 BMSB, ROOM 333 A
Mailing Address - Street 2:1 UNIVERSITY OF NEW MEXICO
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131
Mailing Address - Country:US
Mailing Address - Phone:814-441-0733
Mailing Address - Fax:505-272-8084
Practice Address - Street 1:MSC08 4640 BMSB, ROOM 333 A
Practice Address - Street 2:1 UNIVERSITY OF NEW MEXICO
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131
Practice Address - Country:US
Practice Address - Phone:814-441-0733
Practice Address - Fax:505-272-8084
Is Sole Proprietor?:No
Enumeration Date:2010-12-15
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2012-0599207ZP0007X, 207ZP0105X
PAMT190196390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207ZP0007XAllopathic & Osteopathic PhysiciansPathologyMolecular Genetic Pathology
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine