Individual
DR. SRINIVAS R BRAMHADEVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1497 LAFAYETTE STREET, LAGRANGE, GA 30241-2552
(706) 880-7335
(706) 812-2403
Mailing address
1497 LAFAYETTE STREET, LAGRANGE, GA 30241-2552
(068) 807-3357
(706) 812-2403
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
45129
WI
207Q00000X
Family Medicine Physician
Primary
61946
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34342600
—
WI
05
—
720484389
—
GA
05
—
720484389A
—
GA
01
—
P00972282
RAILROAD MEDICARE
—
Enumeration date
05/31/2006
Last updated
10/03/2019
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