NPI 1659608214

Brahmananda Kiran Koduri, MD

Practitioner Pediatric Critical Care Medicine Physician Gillette, WY

Practice location

Address: 501 S Burma Ave, Gillette, WY 82716-3426
Phone: (307) 688-1534
Mailing address: 4516 Running W Dr APT 101, Gillette, WY 82718-2033

Registered specialties

Pediatric Critical Care Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2080P0203X Licence 9302A (WY)

Other Pediatrics providers in Wyoming →

Registry record

NPI: 1659608214
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Nov 2009
Record last updated: 3 Sep 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.