Healthcare Provider Details

I. General information

NPI: 1912188236
Provider Name (Legal Business Name): NEELIMA KATRAGUNTA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 STANYAN ST
SAN FRANCISCO CA
94117-1019
US

IV. Provider business mailing address

979 E 3RD ST STE 300
CHATTANOOGA TN
37403-2187
US

V. Phone/Fax

Practice location:
  • Phone: 415-379-2900
  • Fax:
Mailing address:
  • Phone: 423-267-0466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number62333
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number62333
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC150896
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number41064
License Number StateIA
# 5
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberC150896
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number41064
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: