Provider Demographics
NPI:1386819381
Name:VELAYUDAM, KOHILAVANI (MD)
Entity Type:Individual
Prefix:DR
First Name:KOHILAVANI
Middle Name:
Last Name:VELAYUDAM
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 1:3500 DULUTH PARK LN STE 600
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3243
Mailing Address - Country:US
Mailing Address - Phone:470-799-1640
Mailing Address - Fax:877-807-0753
Practice Address - Street 1:3500 DULUTH PARK LN STE 600
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3243
Practice Address - Country:US
Practice Address - Phone:470-799-1640
Practice Address - Fax:877-807-0753
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA725842084E0001X, 2084N0402X, 2084N0600X
OH57.0106192084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsy
No2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology