Healthcare Provider Details

I. General information

NPI: 1427136779
Provider Name (Legal Business Name): NEELIMA DACHURI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 WALTON WAY
AUGUSTA GA
30901-2612
US

IV. Provider business mailing address

4155 S LEE ST STE B100
BUFORD GA
30518-3649
US

V. Phone/Fax

Practice location:
  • Phone: 706-774-5795
  • Fax:
Mailing address:
  • Phone: 470-735-8149
  • Fax: 678-563-6061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number58159
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number58159
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: