Tummala, Pavan
Tummala, Pavan is an individual health care provider with primary practice located at 1315 Jesse Jewell Pkwy Ne Ste 300 , Gainesville GA 30501-3875. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Tummala, Pavan can be contacted via phone (770) 219-6520.Contact Information
Primary practice address
1315 Jesse Jewell Pkwy Ne Ste 300
Gainesville GA 30501-3875
Phone: (770) 219-6520
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 2016026000 | Missouri |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 96271 | Georgia |
Profile Details
| NPI number | 1407111313 |
|---|---|
| LBN Legal business name | Tummala, Pavan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2012 |
| Last updated | Oct 18th, 2023 - about 3 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 | 1407111313 | NPPES |
| Missouri | MEDICAID | 200028679 | |
| Missouri | MEDICAID | 1407111313 |
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