Individual
SAILATHA BATHULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1867 REMOUNT RD, STE D, GASTONIA, NC 28054-7401
(704) 854-8799
(704) 854-8803
Mailing address
1867 REMOUNT RD, STE D, GASTONIA, NC 28054-7401
(704) 854-8799
(704) 854-8803
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2005-01725
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141HR
BCBS NC
NC
01
—
5534173
CIGNA
—
05
—
5902486
—
NC
01
—
7178754
AETNA
—
Enumeration date
07/05/2006
Last updated
02/23/2010
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