Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 26148 | NE |
N | 111NI0900X | Internist | 26148 | NE |
N | 207RH0002X | Hospice and Palliative Medicine | 26148 | NE |
N | 207RX0202X | Medical Oncology | 67420 | MN |
Y | 207RX0202X | Medical Oncology | MD.37066 | AL |
NPI | 1114183902 |
---|---|
Provider Name | Dr. Pranitha Vbr Prodduturvar |
First Address | Atlanta, GA 30374-6450 |
Second Address | Mobile, AL 36604-1405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2008 |
Last Update Date | 09/08/2021 |