Basic Information
| Provider Information | |||||||||
| NPI: | 1760686521 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUNDRANDA | ||||||||
| FirstName: | MADAPPA | ||||||||
| MiddleName: | NANAYA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D,PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2940 E. BANNER GATEWAY DR. | ||||||||
| Address2: | SUITE 450 | ||||||||
| City: | GILBERT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4802566444 | ||||||||
| FaxNumber: | 4802564003 | ||||||||
| Practice Location | |||||||||
| Address1: | 2946 E. BANNER GATEWAY DR. | ||||||||
| Address2: | |||||||||
| City: | GILBERT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4802566444 | ||||||||
| FaxNumber: | 4802564683 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2007 | ||||||||
| LastUpdateDate: | 11/16/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | AZ | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 57.011123 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0003X | 41835 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.