Individual
LAXMI TEJASWI AVULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
631 N BROAD STREET EXT, GROVE CITY, PA 16127-4603
(724) 450-7246
(724) 450-7247
Mailing address
631 N BROAD STREET EXT, GROVE CITY, PA 16127-4603
(724) 450-7246
(724) 450-7247
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD479579
PA
208M00000X
Hospitalist Physician
Primary
MD479579
PA
Other
Enumeration date
04/16/2019
Last updated
03/01/2024
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