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General NPI Number Information
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NPI Number | 1033587324
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Entity Type | Organization
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Legal Business Name | NRD MD LLC
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Dates
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Enumeration Date | 09/03/2015
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Last Update Date | 11/11/2015
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Provider Practice Location Address
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Address Line | 2828 HIGHWAY 31 S
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City | DECATUR
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State | AL
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Zip | 35603-1510
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Country | US
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Telephone | 256-350-4855
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Fax |
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Provider Business Mailing Address
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Address Line | 110 BRIDGEHOUSE DR
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City | MADISON
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State | AL
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Zip | 35758-7616
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NAGA H DANTHULURI
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Credential | M.D.
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Telephone | 256-457-2343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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