Provider Demographics
NPI:1265538581
Name:KONDAPAVULURU, PRASAD V (MD)
Entity type:Individual
Prefix:DR
First Name:PRASAD
Middle Name:V
Last Name:KONDAPAVULURU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:105 N MAPLE STREET
Mailing Address - Street 2:STE 4
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-3524
Mailing Address - Country:US
Mailing Address - Phone:615-716-8255
Mailing Address - Fax:615-893-9969
Practice Address - Street 1:105 N MAPLE STREET
Practice Address - Street 2:STE 4
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-3524
Practice Address - Country:US
Practice Address - Phone:615-716-8255
Practice Address - Fax:615-893-9969
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2024-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNMD00000297042084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry