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NPI Code Detail

MEDICARE: THIRUMALA KEERTHI CHANDRIKA KAMMARIPALLE MD

MEDICARE: THIRUMALA KEERTHI CHANDRIKA KAMMARIPALLE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramRTL23-1182NC

General Provider Information

NPI Number : 1386330264
Entity Type Code : Individual
Provider Name (Legal Business Name) : THIRUMALA KEERTHI CHANDRIKA KAMMARIPALLE MD
Provider Business Mailing Address
First Line : 1638 OWEN DR
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-3424
Country : US
Telephone Number : 910-615-3960
Fax Number : 910-615-9907
Provider Business Practice Location Address
First Line : 1638 OWEN DRIVE
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-3424
Country : US
Telephone Number : 910-615-3960
Fax Number : 910-615-9907
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2023
Last Update Date : 06/03/2026

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