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NPI Code Detail

MEDICARE: JYOTHI K GELLA MD

MEDICARE:   JYOTHI K GELLA  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMD065573LPA
2207R00000XInternal Medicine PhysicianMD61256788WA

General Provider Information

NPI Number : 1235124918
Entity Type Code : Individual
Provider Name (Legal Business Name) : JYOTHI K GELLA MD
Provider Business Mailing Address
First Line : 13451 SE 36TH ST
Second Line :
City : BELLEVUE
State : WA
Zip : 98006-1454
Country : US
Telephone Number : 425-562-1337
Fax Number : 425-562-1331
Provider Business Practice Location Address
First Line : 13451 SE 36TH ST
Second Line :
City : BELLEVUE
State : WA
Zip : 98006-1475
Country : US
Telephone Number : 425-562-1337
Fax Number : 425-562-1331
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2005
Last Update Date : 07/22/2022

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