| NPI | 1912288457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TUSHAR NARROTTAM Manager 404-867-3584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X (Licence: GA 61081) |
| Additional Taxonomies | 208D00000X General Practice (Licence: GA 20280) |
| 208VP0000X (Licence: GA 20280) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 20280) | |
| 207Q00000X Family Medicine (Licence: GA 20280) | |
| 207R00000X Internal Medicine (Licence: GA 20280) | |
| 207KA0200X Allergy & Immunology, Allergy (Licence: GA 20280) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: GA 20280) | |
| Enumeration Date | 2011-08-29 |
| Last Update Date | 2022-07-21 |