Individual
DR. PHANI K. DANTULURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 PEACHTREE ST NE, 19TH FLOOR, ATLANTA, GA 30308-2208
(404) 215-2000
(404) 215-2001
Mailing address
550 PEACHTREE ST NE, 19TH FLOOR, ATLANTA, GA 30308-2208
(404) 215-2000
(404) 215-2001
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
063646
GA
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
063646
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269972941A
—
GA
05
—
269972941C
—
GA
05
—
269972941D
—
GA
05
—
269972941E
—
GA
Enumeration date
06/20/2006
Last updated
05/01/2017
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