Individual
DR. SHRAVAN KOORAGAYALU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12502 WILLOWBROOK RD STE 280, CUMBERLAND, MD 21502-6494
(240) 964-8750
(240) 964-8699
Mailing address
PO BOX 1671, CUMBERLAND, MD 21501-1671
(240) 964-8342
(240) 964-8337
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
D90372
MD
207RP1001X
Pulmonary Disease Physician
00292848
NY
207RP1001X
Pulmonary Disease Physician
Primary
D90372
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/12/2012
Last updated
11/27/2023
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