Basic Information
| Provider Information | |||||||||
| NPI: | 1720366222 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KONDA | ||||||||
| FirstName: | PRAMEELA | ||||||||
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| Credential: | M.D., | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23511 CHAGRIN BLVD | ||||||||
| Address2: | APT 319 | ||||||||
| City: | BEACHWOOD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441225528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2163424794 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9500 EUCLID AVE, GENERAL SURGERY | ||||||||
| Address2: | A100 CLEVELAND CLINIC, | ||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2164442009 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2011 | ||||||||
| LastUpdateDate: | 08/01/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 57.019108 | OH | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.