Individual
SATYANARAYANA M DIVVELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-7694
(770) 277-3056
(855) 204-5244
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(855) 851-4405
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
075221
GA
207L00000X
Anesthesiology Physician
261642
NY
208M00000X
Hospitalist Physician
2007019093
MO
Other
Enumeration date
06/07/2007
Last updated
11/04/2016
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