Provider Demographics
NPI:1942401104
Name:PAJERLA, SRAVANTHI (MD)
Entity Type:Individual
Prefix:
First Name:SRAVANTHI
Middle Name:
Last Name:PAJERLA
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 1:2655 NORTHWINDS PKWY
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-2280
Mailing Address - Country:US
Mailing Address - Phone:678-992-1631
Mailing Address - Fax:678-658-4540
Practice Address - Street 1:6184 CARRIAGE TRAIL DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-5359
Practice Address - Country:US
Practice Address - Phone:717-919-0929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND134622084P0804X
MI43010978392084P0804X
IN01073715A2084P0804X
PAMD4398272084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry