Provider Demographics
NPI:1336230770
Name:GUDAPATI, SUDHA SREERAMULU (MD)
Entity Type:Individual
Prefix:
First Name:SUDHA
Middle Name:SREERAMULU
Last Name:GUDAPATI
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 1:3741 FOREST RUN RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BROOK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2127
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 19TH STRET SOUTH
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233
Practice Address - Country:US
Practice Address - Phone:205-933-8101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 71410207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine