Provider Demographics
NPI:1578738233
Name:NAGAPURI, SRINATH (MD)
Entity Type:Individual
Prefix:
First Name:SRINATH
Middle Name:
Last Name:NAGAPURI
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 1:104 OPHELIA CIR
Mailing Address - Street 2:
Mailing Address - City:HARVEST
Mailing Address - State:AL
Mailing Address - Zip Code:35749-4881
Mailing Address - Country:US
Mailing Address - Phone:478-741-7241
Mailing Address - Fax:
Practice Address - Street 1:201 SIVLEY RD SW
Practice Address - Street 2:SUITE 500
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5134
Practice Address - Country:US
Practice Address - Phone:256-265-3880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT4010207R00000X
GA66155207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I112171Medicare PIN