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Individual

SRIDEVI GOWRAVARAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
101 REGENCY PARK DR STE 140, MCDONOUGH, GA 30253-7076
(770) 957-8626
Mailing address
101 REGENCY PARK DR STE 140, MCDONOUGH, GA 30253-7076
(218) 683-2698

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
53897
MN
208000000X
Pediatrics Physician
Primary
72556
GA

Other

Enumeration date
06/16/2006
Last updated
03/09/2016
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