Provider Demographics
NPI:1720303241
Name:EMBAR SRINIVASAN, RAMYA
Entity Type:Individual
Prefix:
First Name:RAMYA
Middle Name:
Last Name:EMBAR SRINIVASAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 HOWARD FARM DR STE 400
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6084
Mailing Address - Country:US
Mailing Address - Phone:470-747-3134
Mailing Address - Fax:404-649-6219
Practice Address - Street 1:3400 OLD MILTON PKWY STE C500
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4408
Practice Address - Country:US
Practice Address - Phone:678-775-2284
Practice Address - Fax:678-775-2285
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA81404207RE0101X
TN53660207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine