Individual
RAVINDRA EDUPUGANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 WHITCHER ST NE, SUITE 350, MARIETTA, GA 30060-1155
(770) 424-6893
(678) 819-0357
Mailing address
55 WHITCHER ST NE STE 350, MARIETTA, GA 30060-1129
(770) 424-6893
(770) 424-9095
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
063858
GA
207UN0901X
Nuclear Cardiology Physician
063858
GA
208600000X
Surgery Physician
063858
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003110591C
—
GA
05
—
003110591D
—
GA
05
—
003110591E
—
GA
05
—
003110591F
—
GA
05
—
003110591G
—
GA
05
—
003110591H
—
GA
05
—
003110591I
—
GA
05
—
003110591J
—
GA
05
—
003110591K
—
GA
05
—
003110591L
—
GA
05
—
003110591M
—
GA
Enumeration date
12/29/2005
Last updated
12/18/2019
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