Individual
MADHU VISHWANATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3969 SOUTH COBB DRIVE SE, SUITE 205, SMYRNA, GA 30080
(770) 438-9723
(770) 431-9733
Mailing address
3969 SOUTH COBB DRIVE SE, SUITE 205, SMYRNA, GA 30080
(770) 438-9723
(770) 431-9733
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
056499
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
821760291C
—
GA
Enumeration date
09/06/2006
Last updated
08/25/2015
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