Koganti, Devendra R
Koganti, Devendra R is an individual health care provider with primary practice located at 6507 Professional Pl , Riverdale GA 30274-4941. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Koganti, Devendra R can be contacted via phone (770) 991-2100.Contact Information
Primary practice address
6507 Professional Pl
Riverdale GA 30274-4941
Phone: (770) 991-2100
Fax: (770) 991-1385
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 030121 | Georgia |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 030121 | Georgia |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 030121 | Georgia |
Profile Details
| NPI number | 1659334829 |
|---|---|
| LBN Legal business name | Koganti, Devendra R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 10th, 2006 |
| Last updated | Sep 26th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659334829 | NPPES |
| Georgia | MEDICAID | 00409912A | |
| Georgia | MEDICAID | 00409912B |
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