Provider Demographics
NPI:1871857391
Name:VADDEPALLY, RAJU KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJU
Middle Name:KUMAR
Last Name:VADDEPALLY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-9567
Mailing Address - Fax:239-343-9571
Practice Address - Street 1:8925 COLONIAL CENTER DR STE 2001
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-7813
Practice Address - Country:US
Practice Address - Phone:239-343-9567
Practice Address - Fax:239-343-9571
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2023-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME164469207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology