Individual
J. MARK RHEUDASIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5673 PEACHTREE DUNWOODY RD NE, SUITE 675, ATLANTA, GA 30342-1731
(678) 843-5400
(678) 843-5449
Mailing address
1838 AMERICAN WAY, LAWRENCEVILLE, GA 30043-6611
(770) 995-7622
(770) 995-7854
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
026926
GA
2086S0129X
Vascular Surgery Physician
Primary
026926
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000635302
—
GA
05
—
000635302J
—
GA
05
—
000635302K
—
GA
05
—
000635302L
—
GA
05
—
000635302M
—
GA
05
—
000635302N
—
GA
05
—
000635302O
—
GA
05
—
000635302P
—
GA
05
—
000635302Q
—
GA
05
—
000635302R
—
GA
05
—
000635302S
—
GA
Enumeration date
02/17/2006
Last updated
09/23/2014
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