Provider Demographics
NPI:1518156033
Name:YELUGAPURI, MURALI MOHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MURALI
Middle Name:MOHAN
Last Name:YELUGAPURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:BLAKELY
Mailing Address - State:GA
Mailing Address - Zip Code:39823-2554
Mailing Address - Country:US
Mailing Address - Phone:229-723-2660
Mailing Address - Fax:229-723-2663
Practice Address - Street 1:360 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:BLAKELY
Practice Address - State:GA
Practice Address - Zip Code:39823-2554
Practice Address - Country:US
Practice Address - Phone:229-723-2660
Practice Address - Fax:229-723-2663
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-21
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301090622208000000X
GA61380208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics