Dr. Pandu Bonthala , MD
General Practice • Nevada, IA
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Pandu Bonthala has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Pandu Bonthala, MD was a registered General Practice practicing in Nevada, IA. Throughout an active medical career spanning 13 years, Dr. Bonthala provided care at the practice location at 624 J AVE until profile deactivation on 2020-12-03.
Practice Location & Contact Primary Location
624 J Ave
Nevada, IA 502011922
Specialty Benchmarks & Practice Insights
Comparative analytics for General Practice in Nevada, IA
Practicing in Nevada, IA (47 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 208D00000X
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on December 03, 2020
NPI status registered as active in NPPES database
Registered at 624 J AVE, NEVADA, IA 502011922 (Tel: 5153822177)
Registered at 624 J AVE, PO BOX 524, NEVADA, IA 502011922 (Tel: 5153822177)
Recorded as PANDU BONTHALA, M.D.
General Practice (License #19977 in IA)
First registered as active Individual Practitioner in NPPES Database.
Patient & Community Reviews
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NPI Administrative Meta
Mailing Address
624 J Ave, Po Box 524
Nevada, IA 502011922
Phone: 5153822177
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