Individual
SRIVIDYA SRINIVASAMAHARAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1831 5TH AVE, COLUMBUS, GA 31904-8915
(706) 320-8780
(706) 320-8721
Mailing address
PO BOX 117339, ATLANTA, GA 30368-7339
(770) 801-2500
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
87471
GA
Other
Enumeration date
04/06/2015
Last updated
10/12/2021
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