Provider Demographics
NPI:1336939552
Name:BOLLEPALLI, NAGASANTOSHA TEJASWINI (MD)
Entity type:Individual
Prefix:
First Name:NAGASANTOSHA
Middle Name:TEJASWINI
Last Name:BOLLEPALLI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 VERMILLION BAY
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55129-6226
Mailing Address - Country:US
Mailing Address - Phone:732-421-8409
Mailing Address - Fax:
Practice Address - Street 1:2130 VERMILLION BAY
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55129-6226
Practice Address - Country:US
Practice Address - Phone:732-421-8409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program