Healthcare Provider Details

I. General information

NPI: 1073254165
Provider Name (Legal Business Name): KAVYA SRI CHERUKURI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5131 BEACON HILL RD STE 340
COLUMBUS OH
43228-4442
US

IV. Provider business mailing address

9930 KINCEY AVE STE 360
HUNTERSVILLE NC
28078-6541
US

V. Phone/Fax

Practice location:
  • Phone: 614-544-1006
  • Fax:
Mailing address:
  • Phone: 704-316-4830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2026-03371
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: