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Individual

MARANDAPALLI R SRIDHARAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1348 WALTON WAY, SUITE 5100, AUGUSTA, GA 30901-5104
(706) 724-8611
(706) 724-6202
Mailing address
1348 WALTON WAY, SUITE 5100, AUGUSTA, GA 30901-5104
(706) 724-8611
(706) 724-6202

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
026392
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
198050
BCBS
GA
05
G26392
SC
Enumeration date
07/19/2006
Last updated
10/22/2007
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