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General NPI Number Information
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NPI Number | 1245497205
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Entity Type | Individual
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Provider Name | SOWJANYA KOLLURI MD
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Gender | Female
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 1000 JOHNSON FERRY ROAD NE KAISER PERMANENTE AT NORTHSIDE HOSPITAL
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City | ATLANTA
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State | GA
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Zip | 30342
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Country | US
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Telephone | 404-851-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 3495 PIEDMONT ROAD, NE NINE PIEDMONT CENTER
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City | ATLANTA
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State | GA
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Zip | 30305
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Country | US
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Telephone | 404-504-5678
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 064628
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0116017630
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License Number State | VA
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