Provider Demographics
NPI:1487979530
Name:DAVULURI, MADHAVI (MD)
Entity type:Individual
Prefix:
First Name:MADHAVI
Middle Name:
Last Name:DAVULURI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 COCHRAN RD
Mailing Address - Street 2:SUITE 490, MANOR OAK TWO
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-1203
Mailing Address - Country:US
Mailing Address - Phone:412-531-2902
Mailing Address - Fax:412-531-2948
Practice Address - Street 1:5000 WATERDAM PLAZA DR
Practice Address - Street 2:SUITE 120
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-5412
Practice Address - Country:US
Practice Address - Phone:724-941-8877
Practice Address - Fax:724-941-4745
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD73348208M00000X
PAMD440499207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1025618290001Medicaid
PAP00887509OtherRAILROAD MEDICARE
PA1025618290001Medicaid