Provider Demographics
NPI:1932165792
Name:GOLI, DURGA PRAMEELA (MD)
Entity Type:Individual
Prefix:MRS
First Name:DURGA
Middle Name:PRAMEELA
Last Name:GOLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5356 STADIUM TRACE PARKWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-5607
Mailing Address - Country:US
Mailing Address - Phone:205-444-4858
Mailing Address - Fax:205-444-4856
Practice Address - Street 1:5356 STADIUM TRACE PARKWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-5607
Practice Address - Country:US
Practice Address - Phone:205-444-4858
Practice Address - Fax:205-444-4856
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16527207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000089960Medicaid
ALF39891Medicare UPIN
AL000089960Medicare ID - Type UnspecifiedMEDICARE PROVIDER #