Healthcare Provider Details

I. General information

NPI: 1861422743
Provider Name (Legal Business Name): ARACHELVI DHANDAYUTHAPANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 05/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

713 20TH ST
COLUMBUS GA
31904-8920
US

IV. Provider business mailing address

PO BOX 4596
COLUMBUS GA
31914-0596
US

V. Phone/Fax

Practice location:
  • Phone: 706-660-8050
  • Fax: 706-256-1030
Mailing address:
  • Phone: 706-660-8050
  • Fax: 706-256-1030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD.27736
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number52166
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: