Basic Information
| Provider Information | |||||||||
| NPI: | 1700129715 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARLAPATI | ||||||||
| FirstName: | SRIKANTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 921 MINERAL RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | GLENVILLE | ||||||||
| State: | WV | ||||||||
| PostalCode: | 263511342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3044627322 | ||||||||
| FaxNumber: | 3044624052 | ||||||||
| Practice Location | |||||||||
| Address1: | 921 MINERAL RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | GLENVILLE | ||||||||
| State: | WV | ||||||||
| PostalCode: | 263511342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3044627322 | ||||||||
| FaxNumber: | 3044624052 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2013 | ||||||||
| LastUpdateDate: | 08/23/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 27063 | WV | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.