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NPI Code Detail

MEDICARE: SREEJAYA VELUVALI M.D.

MEDICARE: SREEJAYA VELUVALI M.D.
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
12084P0800XPsychiatry Physician036112021IL
22084P0802XAddiction Psychiatry Physician49252MN

General Provider Information

NPI Number : 1568462570
Entity Type Code : Individual
Provider Name (Legal Business Name) : SREEJAYA VELUVALI M.D.
Provider Business Mailing Address
First Line : 6810 VALLEY VIEW RD
Second Line :
City : EDINA
State : MN
Zip : 55439-1646
Country : US
Telephone Number : 847-736-6624
Fax Number :
Provider Business Practice Location Address
First Line : 2450 RIVERSIDE AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55454-1450
Country : US
Telephone Number : 612-672-6600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2005
Last Update Date : 07/21/2008

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