DR SIRUVELLA MD PC NPI 1447567631

NPI Information

  • NPI: 1447567631
  • Provider Name: DR SIRUVELLA MD PC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 11D2016456
  • Address: 705 BREEDLOVE DR
    SUITE 800
    MONROE, GA
    ZIP 30655
  • Phone: (770) 266-0567

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NPI Details

DR SIRUVELLA MD PC is a family medicine in Monroe, GA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR SIRUVELLA MD PC NPI is 1447567631. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

705 BREEDLOVE DR
SUITE 800
MONROE, GA
ZIP 30655-090
Phone: (770) 266-0567

The provider's authorized official is Sridevi Siruvella .
The authorized official title is Medical Director/physician and has the following contact phone number (770) 266-0567.

The CLIA number assigned to this NPI record is 11D2016456 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/9/2010 and was last updated on 9/10/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine057019GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1057019OTHERGEORGIASTATE MEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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