Provider Demographics
NPI:1952328668
Name:DEVALAPALLI, VANDANA P (MD,FACP, MHS-CL)
Entity Type:Individual
Prefix:DR
First Name:VANDANA
Middle Name:P
Last Name:DEVALAPALLI
Suffix:
Gender:F
Credentials:MD,FACP, MHS-CL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 WESTONGATE WAY
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-2974
Mailing Address - Country:US
Mailing Address - Phone:919-413-1318
Mailing Address - Fax:
Practice Address - Street 1:4727 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3485
Practice Address - Country:US
Practice Address - Phone:919-413-1318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35875207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8928722Medicaid
NC8928722Medicaid
F41250Medicare UPIN