Individual
DR. VANDANA CHAKRAVARTHY CENTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
11 CHARLIE MORRIS RD, COLBERT, GA 30628-2445
(706) 788-3234
(706) 788-2936
Mailing address
PO BOX 459, COLBERT, GA 30628-0459
(706) 788-3234
(706) 788-2936
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
057054
GA
207R00000X
Internal Medicine Physician
3099
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136315049C
—
GA
Enumeration date
08/15/2006
Last updated
04/17/2015
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