Individual
SRINIVAS KOLIPAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
191 LAMAR HALEY PKWY, CANTON, GA 30114-8019
(770) 704-1600
Mailing address
1503 N TIBBS RD, DALTON, GA 30720-2915
(706) 270-5000
(706) 270-5124
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
2016-00930
NC
2084P0800X
Psychiatry Physician
25890
NE
2084P0800X
Psychiatry Physician
Primary
63677
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831381433
—
NC
05
—
NC2878
—
SC
Enumeration date
08/16/2007
Last updated
06/14/2021
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