Individual provider · Type 1 NPI

Kiran Ponduru

Student in an Organized Health Care Education/Training Program · Minneapolis, MN

NPI number 1003700667 Active

Practice location

701 Park Avenue
Minneapolis, MN 55415

Call (612) 873-6369 Map

Fax (612) 904-4261

Mailing address

701 Park Avenue Minneapolis, Mn 55415-1623
Minneapolis, MN 55415

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1003700667

Kiran Ponduru's National Provider Identifier is 1003700667, issued on Jun 6, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Minneapolis, MN. The record was last updated on Mar 2, 2026.