Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 25MA08716000 | NJ |
Y | 111NI0900X | Internist | 25MA08716000 | NJ |
N | 207RH0002X | Hospice and Palliative Medicine | 25MA08716000 | NJ |
N | 207RN0300X | Nephrologist | MD433841 | PA |
NPI | 1033384706 |
---|---|
Provider Name | Bhargavi Degapudi |
First Address | Linwood, NJ 08221-1382 |
Second Address | Atlantic City, NJ 08401-6804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2008 |
Last Update Date | 05/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0235423 | (05) | NJ |