Provider Demographics
NPI:1619935111
Name:KOMARLA, ARATHI R (MD)
Entity Type:Individual
Prefix:DR
First Name:ARATHI
Middle Name:R
Last Name:KOMARLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ARATHI
Other - Middle Name:
Other - Last Name:RAJENDRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:185 QUEEN CITY AVE
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-7121
Mailing Address - Country:US
Mailing Address - Phone:603-314-6900
Mailing Address - Fax:603-314-6909
Practice Address - Street 1:185 QUEEN CITY AVE
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-7121
Practice Address - Country:US
Practice Address - Phone:603-314-6900
Practice Address - Fax:603-314-6909
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH14879207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30209876Medicaid
NHA4072302Medicare PIN