Provider Demographics
NPI:1457387995
Name:POTHULURI, SARITHA G (MD)
Entity Type:Individual
Prefix:DR
First Name:SARITHA
Middle Name:G
Last Name:POTHULURI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:440 N BARRANCA AVE # 1801
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1722
Mailing Address - Country:US
Mailing Address - Phone:800-924-7811
Mailing Address - Fax:877-349-1868
Practice Address - Street 1:7008 SALEM AVE # 117
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-2226
Practice Address - Country:US
Practice Address - Phone:800-924-7811
Practice Address - Fax:877-349-1868
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV25130207R00000X
TN29421207R00000X
OH35C.000932207R00000X
KYC1982207R00000X
MIEMC0003885207R00000X
TXL3436207R00000X
PAMD484136207R00000X
IL36164241207R00000X
MO2023050318207R00000X
SC91376207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165018604Medicaid
TNQ087135Medicaid
TX443508YLPSOtherWELLMED PTAN