Provider Demographics
NPI:1669583613
Name:GINJUPALLI, MALATHI (MD)
Entity type:Individual
Prefix:DR
First Name:MALATHI
Middle Name:
Last Name:GINJUPALLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MALATHIA
Other - Middle Name:
Other - Last Name:SAKAMURI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:710 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-1527
Mailing Address - Country:US
Mailing Address - Phone:706-571-1823
Mailing Address - Fax:
Practice Address - Street 1:1800 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-1513
Practice Address - Country:US
Practice Address - Phone:706-571-1823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA058415207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine