Provider Demographics
NPI:1528300688
Name:ATLURU, SREEVALLI (MD)
Entity type:Individual
Prefix:
First Name:SREEVALLI
Middle Name:
Last Name:ATLURU
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 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:608-829-5240
Mailing Address - Fax:608-833-0999
Practice Address - Street 1:4131 MERIDIAN DR
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:WI
Practice Address - Zip Code:53598-9699
Practice Address - Country:US
Practice Address - Phone:608-846-3741
Practice Address - Fax:608-833-6965
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WI67740-20207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program