Provider Demographics
NPI:1336593235
Name:BONDALAPATI, SAILAJA (MD)
Entity type:Individual
Prefix:DR
First Name:SAILAJA
Middle Name:
Last Name:BONDALAPATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 PARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ELKIN
Mailing Address - State:NC
Mailing Address - Zip Code:28621-2429
Mailing Address - Country:US
Mailing Address - Phone:336-835-3400
Mailing Address - Fax:335-835-3664
Practice Address - Street 1:177 PARKWOOD DR
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-2429
Practice Address - Country:US
Practice Address - Phone:336-835-3400
Practice Address - Fax:335-835-3664
Is Sole Proprietor?:No
Enumeration Date:2016-04-17
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC2020-02279207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program