Provider Demographics
NPI:1811108251
Name:KONDAPANENI, MURALIDHAR (MBBS PHD)
Entity type:Individual
Prefix:
First Name:MURALIDHAR
Middle Name:
Last Name:KONDAPANENI
Suffix:
Gender:M
Credentials:MBBS PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 GREENWAY PLZ STE 900
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77046-0205
Mailing Address - Country:US
Mailing Address - Phone:171-379-8175
Mailing Address - Fax:
Practice Address - Street 1:473 W 12TH AVE
Practice Address - Street 2:DIVISION OF PULMONARY ALLERGY CRITICAL CARE & SLEEP MED
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1252
Practice Address - Country:US
Practice Address - Phone:614-293-4925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS8061207RC0200X, 207RP1001X
IL036207RP1001X
GUMC-237207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA09995Medicaid