# SIVARAMA K MEDURI MD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952590952
- **Authorized official:** DR. SIVARAMA KRISHNA MEDURI MD (MD/OWNER)
- **Authorized official phone:** (706) 226-1300

## Contact information

- **Practice address:** 1020 CHATTANOOGA AVE STE AB, DALTON, GA 30720-8880
- **Practice address phone:** (706) 226-1300
- **Mailing address:** 1020 CHATTANOOGA AVE STE AB, DALTON, GA 30720-8880
- **Mailing address phone:** (706) 226-1300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RP1001X | Pulmonary Disease Physician | 020055 | GA | Yes |

## Other

- **Enumeration date:** 10/16/2007
- **Last updated:** 10/17/2007