Organization
ATLANTA VEIN CLINIC, LLC
Active
Other names
Atlanta Vein Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
CHALAM MAHADEVAN MD (OWNER)
(404) 805-6167
Entity
Organization
Contact information
Practice address
4060 JOHNS CREEK PKWY, BUILDING E, SUWANEE, GA 30024-1230
(404) 805-6167
Mailing address
4060 JOHNS CREEK PKWY, BUILDING E, SUWANEE, GA 30024-1230
(678) 615-3511
(678) 395-4642
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
059827
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447463609
NPI
GA
Enumeration date
09/26/2008
Last updated
11/18/2022
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