Provider Demographics
NPI:1538789615
Name:DUREMALA, UNKNOWN (MD)
Entity type:Individual
Prefix:
First Name:UNKNOWN
Middle Name:
Last Name:DUREMALA
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Gender:
Credentials:MD
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Mailing Address - Street 1:300 SINGLETON RIDGE RD
Mailing Address - Street 2:ATTENTION CREDENTIALING
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-9142
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 SINGLETON RIDGE RD
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-9142
Practice Address - Country:US
Practice Address - Phone:843-347-7112
Practice Address - Fax:843-347-7113
Is Sole Proprietor?:No
Enumeration Date:2020-04-20
Last Update Date:2025-05-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC93454207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology