Provider Demographics
NPI:1669646477
Name:KURELLA, SREEDEVI (MD)
Entity Type:Individual
Prefix:
First Name:SREEDEVI
Middle Name:
Last Name:KURELLA
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 1:1500 FOREST GLEN RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1484
Mailing Address - Country:US
Mailing Address - Phone:301-754-7908
Mailing Address - Fax:301-754-7324
Practice Address - Street 1:1500 FOREST GLEN RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1484
Practice Address - Country:US
Practice Address - Phone:301-754-7908
Practice Address - Fax:301-754-7324
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301078251207ZP0102X
DCMD039828207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology