Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 2006-01227 | NC |
NPI | 1093863235 |
---|---|
Provider Name | Lankala Chandra Shekar Reddy |
First Address | Durham, NC 27713-4430 |
Second Address | Durham, NC 27705-3941 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2007 |
Last Update Date | 28/03/2011 |