Provider Demographics
NPI:1922022193
Name:KONDAPANENI, PRANATHI (MD)
Entity Type:Individual
Prefix:DR
First Name:PRANATHI
Middle Name:
Last Name:KONDAPANENI
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 1:100 KIMBALL PL STE 100
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-2614
Mailing Address - Country:US
Mailing Address - Phone:678-990-3962
Mailing Address - Fax:678-840-3777
Practice Address - Street 1:4245 JOHNS CREEK PKWY STE A
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-9122
Practice Address - Country:US
Practice Address - Phone:678-990-3962
Practice Address - Fax:678-840-3777
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010778242084N0400X
GA594472084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology