Provider Demographics
NPI:1073570297
Name:THATI, ARUNA DEVI AMARA (MD)
Entity Type:Individual
Prefix:
First Name:ARUNA DEVI
Middle Name:AMARA
Last Name:THATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1832 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-6311
Mailing Address - Country:US
Mailing Address - Phone:931-645-3552
Mailing Address - Fax:
Practice Address - Street 1:1832 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-6311
Practice Address - Country:US
Practice Address - Phone:931-645-3552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000036763207Q00000X
CT040253207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine