Individual
THARA MRITHULA VIDYASAGARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322
(404) 712-7100
Mailing address
1364 CLIFTON RD NE, ATLANTA, GA 30322-0001
(404) 712-7100
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
075697
GA
Other
Enumeration date
07/25/2012
Last updated
06/18/2018
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