Individual provider · NPI-1

Dr. Srinivas R Bramhadevi, MD

Family Medicine · Lagrange, GA

NPI number1750338968
StatusActive
Last updated in NPPESOct 3, 2019

Details

NPI
1750338968
Entity type
Individual (NPI-1)
Name
Dr. Srinivas R Bramhadevi
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
May 31, 2006
Last updated
Oct 3, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine61946GAYes
207Q00000X Family Medicine45129WI

Practice location

1497 Lafayette Street
Lagrange, GA 30241-2552

Phone 706-880-7335 · Fax 706-812-2403

Mailing address

1497 Lafayette Street
Lagrange, GA 30241-2552

Phone 068-807-3357 · Fax 706-812-2403

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