Provider Demographics
NPI:1730387697
Name:VEDULA, GIRIDHAR VENKATA (MD)
Entity type:Individual
Prefix:DR
First Name:GIRIDHAR
Middle Name:VENKATA
Last Name:VEDULA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1968 PEACHTREE RD NW BLDG 5TH
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1281
Mailing Address - Country:US
Mailing Address - Phone:404-605-4600
Mailing Address - Fax:404-367-4447
Practice Address - Street 1:1968 PEACHTREE RD NW BLDG 775TH
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1281
Practice Address - Country:US
Practice Address - Phone:404-605-4600
Practice Address - Fax:404-367-4447
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME110289204F00000X, 208600000X
CODR.0062058204F00000X
GA90758204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery