Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 21558 | SC |
N | 111NI0900X | Internist | 21558 | SC |
Y | 207RH0003X | Hematology & Oncology | 21558 | SC |
NPI | 1033186713 |
---|---|
Provider Name | Dr. Vijaya Korrapati |
First Address | West Columbia, SC 29171-6069 |
Second Address | West Columbia, SC 29169-4848 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2006 |
Last Update Date | 09/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
215583 | (05) | SC |
H13780 | (02) |