Basic Information
| Provider Information | |||||||||
| NPI: | 1114999257 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PRATURI | ||||||||
| FirstName: | RAJASREE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1731 MERIWEATHER DR | ||||||||
| Address2: | STE 102 | ||||||||
| City: | BOGART | ||||||||
| State: | GA | ||||||||
| PostalCode: | 306223046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7062277204 | ||||||||
| FaxNumber: | 7062277225 | ||||||||
| Practice Location | |||||||||
| Address1: | 465 WINN WAY STE 221 | ||||||||
| Address2: | |||||||||
| City: | DECATUR | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300301723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4042923810 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2006 | ||||||||
| LastUpdateDate: | 02/04/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 049935 | GA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.