Provider Demographics
NPI:1235490780
Name:AVDHANI, SREEDEVI VELUVARTI (MD)
Entity Type:Individual
Prefix:
First Name:SREEDEVI
Middle Name:VELUVARTI
Last Name:AVDHANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SREEDEVI
Other - Middle Name:
Other - Last Name:VELUVARTI VENKATA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3500 MCCLURE BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3131
Mailing Address - Country:US
Mailing Address - Phone:770-476-3636
Mailing Address - Fax:770-476-5845
Practice Address - Street 1:3500 MCCLURE BRIDGE RD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3131
Practice Address - Country:US
Practice Address - Phone:770-476-3636
Practice Address - Fax:770-476-5845
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2024-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT201542207R00000X
MST3233207RE0101X
GA80411207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA080411OtherGA MEDICAL LICENSE