Provider Demographics
NPI:1023183399
Name:CARDIOPULMONARY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:CARDIOPULMONARY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMANA
Authorized Official - Middle Name:V
Authorized Official - Last Name:KALLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-741-1118
Mailing Address - Street 1:770 PINE ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-2173
Mailing Address - Country:US
Mailing Address - Phone:478-741-1118
Mailing Address - Fax:478-750-9301
Practice Address - Street 1:770 PINE ST
Practice Address - Street 2:SUITE 310
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2173
Practice Address - Country:US
Practice Address - Phone:478-741-1118
Practice Address - Fax:478-750-9301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5500064444449AMedicaid
GAGRP685Medicare ID - Type Unspecified