Provider Demographics
NPI:1104147214
Name:BONDALAPATI, NAVEEN KUMAR REDDY (MD)
Entity type:Individual
Prefix:
First Name:NAVEEN
Middle Name:KUMAR REDDY
Last Name:BONDALAPATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:670 MASON RIDGE CENTER DR
Mailing Address - Street 2:STE 300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8573
Mailing Address - Country:US
Mailing Address - Phone:314-653-5643
Mailing Address - Fax:314-653-5648
Practice Address - Street 1:4500 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226-5360
Practice Address - Country:US
Practice Address - Phone:618-233-3066
Practice Address - Fax:618-257-6679
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN11015290A207Q00000X
MO2013016093208M00000X
IL036145820208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine