Healthcare Provider Details

I. General information

NPI: 1386132421
Provider Name (Legal Business Name): VARSHAA KONERU M.B.B.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2018
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EMORY UNIVERSITY HOSPITAL MIDTOWN 550 PEACHTREE ST, NE, 19TH FLOOR, STE 1950
ATLANTA GA
30308
US

IV. Provider business mailing address

EMORY UNIVERSITY HOSPITAL MIDTOWN 550 PEACHTREE ST, NE, 19TH FLOOR, STE 1950
ATLANTA GA
30308
US

V. Phone/Fax

Practice location:
  • Phone: 404-686-4411
  • Fax:
Mailing address:
  • Phone: 404-686-4411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number1027965
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number102773
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: