| NPI | 1629653563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAGASASIKANTH R MOPURI Owner 404-702-0995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 163WP0808X Registered Nurse, Psych/Mental Health | |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| 207VX0000X Obstetrics & Gynecology, Obstetrics | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 225100000X Physical Therapist | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2021-03-12 |
| Last Update Date | 2024-09-05 |