Provider Demographics
NPI:1225093461
Name:VANAPALLI, TULASI RAMA (MD)
Entity Type:Individual
Prefix:MRS
First Name:TULASI
Middle Name:RAMA
Last Name:VANAPALLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1115 MOUNT ZION RD
Mailing Address - Street 2:SUITE J
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-2266
Mailing Address - Country:US
Mailing Address - Phone:770-968-7421
Mailing Address - Fax:770-960-0078
Practice Address - Street 1:1115 MOUNT ZION RD
Practice Address - Street 2:SUITE J
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-2266
Practice Address - Country:US
Practice Address - Phone:770-968-7421
Practice Address - Fax:770-960-0078
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA024504207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA11SCFNTMedicare ID - Type Unspecified
D31081Medicare UPIN