Healthcare Provider Details

I. General information

NPI: 1790246890
Provider Name (Legal Business Name): SRIHARSHA RALLAPALLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2019
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 W CLAY ST
SYLACAUGA AL
35150-3413
US

IV. Provider business mailing address

1203 W MAGNOLIA DR
SYLACAUGA AL
35150-4523
US

V. Phone/Fax

Practice location:
  • Phone: 256-245-3267
  • Fax:
Mailing address:
  • Phone: 256-487-2526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD.42147
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: