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Physician Compare National (NPI:1891706974)

HEALTHCARE PROVIDER: SYAMALA D ERRAMILLI MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1891706974
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 4486671401
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20051031000194
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name ERRAMILLI
Individual professional last name
Provider First Name SYAMALA
Individual professional first name
Provider Middle Name DEVI
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.
Provider Credential Text MD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 1976
Individual professional's medical school graduation year
Primary Specialty INTERNAL MEDICINE
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 2926 MOUNTAIN INDUSTRIAL BLVD
Group Practice or individual's line 1 address
City TUCKER
Group Practice or individual's city
State GA
Group Practice or individual's state
Zip Code 300843012
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 110087
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 GWINNETT MEDICAL CENTER
Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment Y

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