| NPI | 1053198226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YUGANDHAR KANDIMALLA Vice President 678-982-3590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism | |
| 207RI0200X Internal Medicine Infectious Disease | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 2085R0202X Radiology Diagnostic Radiology | |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist | |
| 261QU0200X Clinic/Center Urgent Care | |
| Enumeration Date | 2023-09-12 |
| Last Update Date | 2024-05-28 |