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Individual

DR. NAGALAKSHMI CHARITHA SURYADEVARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1968 PEACHTREE RD NW, ATLANTA, GA 30309-1281
(404) 605-3248
Mailing address
517 BROOKESHYRE CT, WOODSTOCK, GA 30188-3199
(770) 592-3245

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
058515
GA
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
058515
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
378304400C
GA
05
378304400D
GA
05
378304400F
GA
Enumeration date
05/16/2007
Last updated
02/26/2021
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