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General NPI Number Information
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NPI Number | 1043303084
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Entity Type | Individual
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Provider Name | ANAND DEVIPRAKASH UDUPA MD
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 4450 CALIBRE XING NW STE 1126
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City | ACWORTH
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State | GA
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Zip | 30101-4104
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Country | US
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Telephone | 470-227-8130
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Fax | 470-747-7588
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Provider Business Mailing Address
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Address Line | 4450 CALIBRE XING NW STE 1126
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City | ACWORTH
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State | GA
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Zip | 30101-4104
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Country | US
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Telephone | 470-227-8130
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Fax | 470-747-7588
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 101941
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License Number State | GA
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