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General NPI Number Information
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NPI Number | 1487572673
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Entity Type | Individual
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Provider Name | DURGAPRASAD KONDAPURAM
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Gender | Male
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Dates
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Enumeration Date | 07/07/2026
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Last Update Date | 07/07/2026
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Provider Practice Location Address
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Address Line | UMASS BAYSTATE MEDICAL CENTER
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City | SPRINGFIELD
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State | MA
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Zip | 01199-0001
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Country | US
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Telephone | 413-794-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 188 DUSKY LN
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City | SUFFIELD
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State | CT
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Zip | 06078-1954
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Country | US
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Telephone | 413-421-5648
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 3019721
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License Number State | MA
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