| Doctor Name: | MRIDULA VINJAMURI |
| NPI Number: | 1063613503 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 24264 |
| Business Practice Address: | 1708 Forest Dr Suite 101 Corbin, KY - 407012327 |
| Business Phone Number: | 6065285000 |
| Business Fax Number: | 6065825113 |
| Mailing Address: | 520 Techwood Drive, Suite 100 DANVILLE |
| State: | KY |
| Postal Code: | 404228500 |
| Phone Number: | 8599369844 |
| Fax Number: | 8592360320 |
| NPI Enumeration Date: | 05/31/2007 |
| NPI Last Update Date: | 02/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RH0003X |
| License Number: | 24264 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NE |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Hematology & Oncology |
| Taxonomy Definition: | An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |