Provider Demographics
NPI:1477873354
Name:AKKINENI, MADHAVI (MD)
Entity Type:Individual
Prefix:
First Name:MADHAVI
Middle Name:
Last Name:AKKINENI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:597 OLD MOUNT HOLLY RD
Mailing Address - Street 2:STE 202
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-2832
Mailing Address - Country:US
Mailing Address - Phone:843-466-8000
Mailing Address - Fax:800-617-7918
Practice Address - Street 1:597 OLD MOUNT HOLLY RD
Practice Address - Street 2:STE 202
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-2832
Practice Address - Country:US
Practice Address - Phone:843-466-8000
Practice Address - Fax:800-617-7918
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC33988207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine