Provider Demographics
NPI:1265726384
Name:KOLAKALAPUDI, PAVANI (MD)
Entity type:Individual
Prefix:DR
First Name:PAVANI
Middle Name:
Last Name:KOLAKALAPUDI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3970 DEPUTY BILL CANTRELL MEM STE 100
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-3069
Mailing Address - Country:US
Mailing Address - Phone:678-513-2273
Mailing Address - Fax:678-513-8869
Practice Address - Street 1:1404 RIVER PL STE 501
Practice Address - Street 2:
Practice Address - City:BRASELTON
Practice Address - State:GA
Practice Address - Zip Code:30517-5600
Practice Address - Country:US
Practice Address - Phone:770-534-2020
Practice Address - Fax:770-534-8025
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2022-03-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA078781207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease