MURALIDHAR REDDY IDAMAKANTI

BRONX, NY
NPI1740621481
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207R00000X Internal Medicine
(Licence: NY  288072)
Enumeration Date2013-07-10
Last Update Date2020-05-14
Business Address
MURALIDHAR REDDY IDAMAKANTI MD
4422 3RD AVE DEPT OF INTERNAL MED
BRONX, NY 10457-2545
Phone number: 718-960-6202
Mailing Address
MURALIDHAR REDDY IDAMAKANTI MD
PO BOX 26666 PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-6770