Sandhya V Koppula


Address: 17200 Nw Corridor Ct, Suite 112, Beaverton, OR 97006-3295
Phone: 5034396969

Sandhya V Koppula (NPI# 1962487231, PAC ID# 6800073701) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.

Physician Overview

Nation Provider ID (NPI) 1962487231
PAC ID by PECOS 6800073701
Professional Enrollment ID I20110601000650
Full Name Sandhya V Koppula
Address 17200 Nw Corridor Ct
Suite 112
Beaverton
OR 97006-3295
Phone Number 5034396969
Gender F
Medical School OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduation Year 1995
Primary Specialty DERMATOLOGY
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
380009 OHSU HOSPITAL

Other Locations

Address Phone Organization
17200 Nw Corridor Ct, Suite 112, Beaverton, OR 97006-3295 5034396969

Organization Information

Office Location

Street Address 17200 NW CORRIDOR CT
SUITE 112
City BEAVERTON
State OR
Zip 97006-3295

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Competitor

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City BEAVERTON
Zip Code 97006
Specialty DERMATOLOGY
City + Specialty BEAVERTON + DERMATOLOGY

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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