Provider Demographics
NPI:1699269258
Name:SRAVANTHI, METLAPALLI VENKATA (MD)
Entity type:Individual
Prefix:
First Name:METLAPALLI VENKATA
Middle Name:
Last Name:SRAVANTHI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-3607
Mailing Address - Country:US
Mailing Address - Phone:304-637-3640
Mailing Address - Fax:304-637-3654
Practice Address - Street 1:801 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-3607
Practice Address - Country:US
Practice Address - Phone:304-637-3826
Practice Address - Fax:304-637-3441
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV33878207R00000X, 207RH0003X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program