Provider Demographics
NPI:1023119781
Name:CHOUDARY, KAVITHA ALURI (MD)
Entity type:Individual
Prefix:DR
First Name:KAVITHA
Middle Name:ALURI
Last Name:CHOUDARY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KAVITHA
Other - Middle Name:
Other - Last Name:ALURI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7073 CLYO RD
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4816
Mailing Address - Country:US
Mailing Address - Phone:937-435-5857
Mailing Address - Fax:937-912-4960
Practice Address - Street 1:7073 CLYO RD
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4816
Practice Address - Country:US
Practice Address - Phone:937-435-5857
Practice Address - Fax:937-912-4960
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.079545207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2293683Medicaid
OH2293683Medicaid
4065735Medicare UPIN
OH4065736Medicare PIN