Individual provider · NPI-1

Dr. Jyothi Dyavanapalli Gudla, M.D

Internal Medicine, Geriatric Medicine · Canton, OH

NPI number1194872713
StatusActive
Last updated in NPPESNov 19, 2024

Details

NPI
1194872713
Entity type
Individual (NPI-1)
Name
Dr. Jyothi Dyavanapalli Gudla
Credential
M.D
Sex
Female
Sole proprietor
No
Enumeration date
Jan 4, 2007
Certification date
Nov 19, 2024
Last updated
Nov 19, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207RG0300X Internal Medicine, Geriatric Medicine35.083145OHYes
208M00000X Hospitalist35-083145OH
207R00000X Internal Medicine35-083145OH
207R00000X Internal Medicine35.083145OH

Other names

  • Jyothi D Gudla (Professional Name)

Practice location

4808 Munson St Nw
Canton, OH 44718-3613

Phone 330-622-0207 · Fax 330-832-3499

Mailing address

4808 Munson St Nw
Canton, OH 44718-3613

Phone 330-460-4115 · Fax 330-832-3499

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