Individual
DR. KAVITHA TELLAKULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3400 OLD MILTON PKWY STE A130, ALPHARETTA, GA 30005-4417
(770) 664-8898
(770) 772-4377
Mailing address
3400A OLD MILTON PARKWAY, SUITE 130, ALPHARETTA, GA 30005-4438
(770) 664-8898
(770) 772-4377
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
061762
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003149881A
—
GA
Enumeration date
05/01/2008
Last updated
10/12/2020
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