Provider Demographics
NPI:1427136779
Name:DACHURI, NEELIMA (MD)
Entity type:Individual
Prefix:
First Name:NEELIMA
Middle Name:
Last Name:DACHURI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 MCCLURE BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3223
Mailing Address - Country:US
Mailing Address - Phone:470-325-0100
Mailing Address - Fax:470-325-0193
Practice Address - Street 1:3215 MCCLURE BRIDGE RD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3223
Practice Address - Country:US
Practice Address - Phone:470-325-0100
Practice Address - Fax:470-325-0193
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2023-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA058159207R00000X
GA58159208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA058159OtherMEDICAL LICENSE