Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301094198 | MI |
N | 111NI0900X | Internist | 4301094198 | MI |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 2015009833 | MO |
N | 207RC0000X | Internist - Cardiovascular Disease | 04-38781 | KS |
N | 207RC0000X | Internist - Cardiovascular Disease | 2015009833 | MO |
NPI | 1699903690 |
---|---|
Provider Name | Dr. Deepthi Vodnala |
First Address | Saint Louis, MO 63150-5008 |
Second Address | Overland Park, KS 66213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2009 |
Last Update Date | 10/07/2018 |