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1740621481
MURALIDHAR REDDY IDAMAKANTI
BRONX, NY
NPI
1740621481
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: NY 288072)
Enumeration Date
2013-07-10
Last Update Date
2020-05-14
Business Address
MURALIDHAR REDDY IDAMAKANTI MD
4422 3RD AVE DEPT OF INTERNAL MED
BRONX, NY 10457-2545
Phone number: 718-960-6202
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Mailing Address
MURALIDHAR REDDY IDAMAKANTI MD
PO BOX 26666 PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-6770
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