Healthcare Provider Details

I. General information

NPI: 1184681207
Provider Name (Legal Business Name): KRISHNA DEVULAPALLI M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 10/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 CHURCHILL HUBBARD RD
YOUNGSTOWN OH
44505-1332
US

IV. Provider business mailing address

615 CHURCHILL HUBBARD RD
YOUNGSTOWN OH
44505-1332
US

V. Phone/Fax

Practice location:
  • Phone: 330-758-4515
  • Fax: 330-758-2862
Mailing address:
  • Phone: 330-758-4515
  • Fax: 330-758-2862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: KRISHNA DEVULAPALLI
Title or Position: OWENER
Credential: M.D
Phone: 330-758-4515