Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MT198535 | PA |
N | 111NI0900X | Internist | MT198535 | PA |
N | 207RH0000X | Hematologist | 86342 | GA |
Y | 207RX0202X | Medical Oncology | 086342 | GA |
NPI | 1073800629 |
---|---|
Provider Name | Mrs. Shravanti Macherla |
First Address | Gainesville, GA 30503-0658 |
Second Address | Gainesville, GA 30501-3834 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2011 |
Last Update Date | 11/09/2020 |