Individual
SIVARAMA KRISHNA MEDURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1020 CHATTANOOGA AVE, STE A&B, DALTON, GA 30720
(706) 226-1300
(706) 275-6478
Mailing address
1020 CHATTANOOGA AVE, STE A&B, DALTON, GA 30720
(706) 226-1300
(706) 275-6478
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
020055
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85000113G
—
GA
Enumeration date
07/15/2006
Last updated
07/08/2007
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