Provider Demographics
NPI:1336111558
Name:JALAGANI, HARINI (MD)
Entity Type:Individual
Prefix:MRS
First Name:HARINI
Middle Name:
Last Name:JALAGANI
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 1:962 JOE FRANK HARRIS PKWY SE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-2154
Mailing Address - Country:US
Mailing Address - Phone:770-607-7123
Mailing Address - Fax:770-607-7074
Practice Address - Street 1:962 JOE FRANK HARRIS PKWY SE
Practice Address - Street 2:SUITE 207
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-2154
Practice Address - Country:US
Practice Address - Phone:770-607-7123
Practice Address - Fax:770-607-7074
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056103207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA997740369BMedicaid
GA521884010002OtherBCBS
GA932875OtherBCBS
GA521884010002OtherBCBS
P00322672Medicare PIN
GA511G700949Medicare PIN
I38209Medicare UPIN