Organization
ENDOHEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAYATHRI K DEVINENI M.D (DR)
(678) 829-6030
Entity
Organization
Contact information
Practice address
1690 STONE VILLAGE LN NW STE 207, KENNESAW, GA 30152-7778
(678) 829-6030
Mailing address
240 GLEN LAKE DR, ATLANTA, GA 30327-4818
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
061573
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619154184
NUPIN
GA
Enumeration date
03/15/2017
Last updated
03/31/2017
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