Individual
MRS. SANTHI ADIGOPULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 S ENOTA DR NE STE 100, GAINESVILLE, GA 30501-3466
(770) 534-2020
(770) 534-8025
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
0101265209
VA
207RC0000X
Cardiovascular Disease Physician
Primary
068470
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003128905A
—
GA
01
—
01720105
AMERIGROUP
GA
01
—
722915
WELLCARE
GA
01
—
P01142578
RR MEDICARE
GA
Enumeration date
10/02/2008
Last updated
07/19/2021
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