Individual
SRAVANTHI NANDAVARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 724-0454
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2621
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME143925
FL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
1017105
MA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
51127
KY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME143925
FL
207RP1001X
Pulmonary Disease Physician
1017105
MA
207RP1001X
Pulmonary Disease Physician
Primary
51127
KY
207RP1001X
Pulmonary Disease Physician
ME143925
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
09/19/2011
Last updated
11/07/2023
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