Provider Demographics
NPI:1285613133
Name:AKULA, DEVENDER N (MD)
Entity type:Individual
Prefix:
First Name:DEVENDER
Middle Name:N
Last Name:AKULA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2500 ENGLISH CREEK AVE.
Mailing Address - Street 2:BLDG 200, STE 211
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234
Mailing Address - Country:US
Mailing Address - Phone:609-677-7776
Mailing Address - Fax:856-428-5748
Practice Address - Street 1:2500 ENGLISH CREEK AVE.
Practice Address - Street 2:BLDG 200, STE 211
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234
Practice Address - Country:US
Practice Address - Phone:609-677-7776
Practice Address - Fax:609-677-7509
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07142700207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ091512OtherMEDICARE PTAN
NJ0069264Medicaid
NJ0069264Medicaid