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General NPI Number Information
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NPI Number | 1477235372
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Entity Type | Organization
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Legal Business Name | SVAP MED LLC
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Dates
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Enumeration Date | 08/01/2023
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 535 JESSE JEWELL PKWY SE STE A
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City | GAINESVILLE
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State | GA
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Zip | 30501-3772
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Country | US
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Telephone | 407-310-3140
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Fax | 478-974-5114
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Provider Business Mailing Address
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Address Line | 7778 MCGINNIS FERRY RD # 286
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City | SUWANEE
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State | GA
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Zip | 30024-1622
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Country | US
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Telephone | 407-310-3140
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Fax | 478-974-5114
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Authorized Official
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Title or Position | OWNER
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Name | SWETHA ADDAGATLA
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Credential | MD
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Telephone | 423-737-4775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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