Provider Demographics
NPI:1700951308
Name:KALLI, RAMANA V (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMANA
Middle Name:V
Last Name:KALLI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:770 PINE ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-2173
Mailing Address - Country:US
Mailing Address - Phone:478-741-1118
Mailing Address - Fax:478-750-9301
Practice Address - Street 1:770 PINE ST
Practice Address - Street 2:SUITE 310
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2173
Practice Address - Country:US
Practice Address - Phone:478-741-1118
Practice Address - Fax:478-750-9301
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2022-09-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA023174207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00237817AMedicaid
GAD40313Medicare UPIN