Individual
HARSHA VARDHAN REDDY BANAVASI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1825 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(762) 235-2150
(706) 291-8380
Mailing address
221 TECHNOLOGY PKWY NW, ROME, GA 30165-1369
(762) 235-1000
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
84103
GA
Other
Enumeration date
05/12/2014
Last updated
06/16/2020
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