Provider Demographics
NPI:1073803474
Name:KALARITHARA, SHERIL (MD)
Entity Type:Individual
Prefix:
First Name:SHERIL
Middle Name:
Last Name:KALARITHARA
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 1:741 FREDERICA ST NE
Mailing Address - Street 2:APT 25
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-4237
Mailing Address - Country:US
Mailing Address - Phone:718-909-3809
Mailing Address - Fax:
Practice Address - Street 1:10 PARK PLACE SOUTH SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-2913
Practice Address - Country:US
Practice Address - Phone:404-616-4784
Practice Address - Fax:404-616-5500
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0715192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003169843AMedicaid