Individual
DR. SRIVIDYA NUKALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1800 10TH AVE, COLUMBUS, GA 31901-1529
(706) 321-3710
Mailing address
4602 DEPT, CAROL STREAM, IL 60122-0021
(906) 225-4821
(906) 225-4537
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301090338
MI
207R00000X
Internal Medicine Physician
Primary
66348
GA
Other
Enumeration date
09/13/2007
Last updated
04/17/2019
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