Individual
DR. JAYASRI MALLAVARAPU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D., M.P.H.
Contact information
Practice address
1614 PEACHTREE PKWY, SUITE 200, CUMMING, GA 30041-6883
(678) 455-2295
(678) 455-2279
Mailing address
1614 PEACHTREE PKWY, SUITE 200, CUMMING, GA 30041-6883
(678) 455-2295
(678) 455-2279
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
061288
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235309469
NPI
—
05
—
157049240C
—
GA
Enumeration date
03/04/2008
Last updated
03/26/2014
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