Provider Demographics
NPI:1710747142
Name:KALVAPUDI, DEVAKI
Entity Type:Individual
Prefix:
First Name:DEVAKI
Middle Name:
Last Name:KALVAPUDI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 RIVER PL STE 200
Mailing Address - Street 2:
Mailing Address - City:BRASELTON
Mailing Address - State:GA
Mailing Address - Zip Code:30517-5603
Mailing Address - Country:US
Mailing Address - Phone:770-848-6140
Mailing Address - Fax:
Practice Address - Street 1:1515 RIVER PL STE 200
Practice Address - Street 2:
Practice Address - City:BRASELTON
Practice Address - State:GA
Practice Address - Zip Code:30517-5603
Practice Address - Country:US
Practice Address - Phone:770-848-6140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program