Individual provider · Type 1 NPI

Chandra Kumar Mallic Kodavanti, MD

Critical Care Medicine (Internal Medicine) Physician · Dothan, AL

NPI number 1093236580 Active

Practice location

1108 Ross Clark Cir
Dothan, AL 36301-3022

Call (334) 703-8836 Map

Fax (334) 712-3512

Mailing address

PO Box 1928
Dothan, AL 36302-1928

Other practice locations

  • Msc 10-5550 1 University Of New Mexico, Albuquerque, NM 87131-0001 · (505) 272-4751
  • 701 W 5th St, Odessa, TX 79763-4206 · (432) 703-5375

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program 390200000XRS2020-0463 (NM)
Student in an Organized Health Care Education/Training Program 390200000XBP10060414 (TX)
Critical Care Medicine (Internal Medicine) Physician Primary 207RC0200XMD.46417 (AL)

Critical Care Medicine (Internal Medicine) Physician: An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

201 other providers at this address

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About NPI 1093236580

Chandra Kumar Mallic Kodavanti, MD's National Provider Identifier is 1093236580, issued on Jul 5, 2017. The primary taxonomy on file is Critical Care Medicine (Internal Medicine) Physician (207RC0200X), and the practice location is in Dothan, AL. The record was last updated on Jul 25, 2023.