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Organization
ATLANTA VASCULAR AND VEIN CENTER, LLC
Active
Organization
ATLANTA VASCULAR AND VEIN CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMISH TILARA MD (PRESIDENT)
(973) 632-8372
Entity
Organization
Contact information
Practice address
600 PROFESSIONAL DR, SUITE 160A, LAWRENCEVILLE, GA 30046-7651
(973) 632-8372
Mailing address
1873 ROYAL TROON CT, DULUTH, GA 30097-5234
(973) 632-2385
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
NULL
261QR0200X
Radiology Clinic/Center
—
NULL
Other
Enumeration date
05/02/2015
Last updated
08/24/2015
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