Individual
DAMODHAR NERELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
819 N FANT ST, ANDERSON, SC 29621-5717
(864) 261-1800
(864) 261-1856
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
27041
SC
208M00000X
Hospitalist Physician
Primary
98490
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
097697620A
GEORGIA MEDICAID
—
05
—
270414
—
SC
01
—
P00156020
RR MEDICARE
SC
01
—
P00855848
RR MEDICARE EFF 10-10
SC
Enumeration date
05/09/2006
Last updated
07/21/2025
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