Provider Demographics
NPI:1982165882
Name:GORTHALA, SISIRA (MD)
Entity type:Individual
Prefix:
First Name:SISIRA
Middle Name:
Last Name:GORTHALA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:21 MORGAN DR
Mailing Address - Street 2:
Mailing Address - City:NORTH GRAFTON
Mailing Address - State:MA
Mailing Address - Zip Code:01536-2212
Mailing Address - Country:US
Mailing Address - Phone:828-713-8059
Mailing Address - Fax:
Practice Address - Street 1:7 REGIONAL CIRCLE
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-9796
Practice Address - Country:US
Practice Address - Phone:910-715-8600
Practice Address - Fax:910-235-7927
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2025-03305207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease