Individual
JAWAHAR REDDY GAZZALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1468 MONTREAL RD, TUCKER, GA 30084
(470) 273-6263
(678) 916-4957
Mailing address
1468 MONTREAL RD, TUCKER, GA 30084-6901
(470) 273-6263
(678) 916-4957
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
34141
AL
207RC0000X
Cardiovascular Disease Physician
Primary
79419
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP10039371
TEXAS MEDICAL BOARD
TX
Enumeration date
07/16/2008
Last updated
07/05/2018
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