IndividualActive
Chandra Kumar Mallic Kodavanti, MD
NPI 1093236580 · Critical Care Medicine (Internal Medicine) Physician · Dothan, AL
Provider details
- NPI number
- 1093236580
- Entity type
- Individual
- Primary specialty
- Critical Care Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- RS2020-0463 (NM)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Student, Health Care
Student, Health Care
Practice location
1108 Ross Clark Cir
Dothan, AL 36301-3022
Phone: (334) 703-8836
Fax: (334) 712-3512
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 1928
Dothan, AL 36302-1928
Additional practice locations (2)
- Msc 10-5550 1 University of New MexicoAlbuquerque, NM 87131-0001Phone: (505) 272-4751Fax: (505) 272-8700
- 701 W 5th StOdessa, TX 79763-4206Phone: (432) 703-5375
Registry dates
- Enumerated
- 2017-07-05
- Last updated
- 2023-07-25
- Certified
- 2023-07-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.