Individual
MADHAVI M NAIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
106 LUKKEN INDUSTRIAL DR W, LAGRANGE, GA 30240-5912
(706) 880-7204
(706) 880-7289
Mailing address
106 LUKKEN INDUSTRIAL DR W, LAGRANGE, GA 30240-5912
(706) 880-7204
(706) 880-7289
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
048548
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00012515D
—
GA
01
—
160049424
RAILROAD MEDICARE
GA
01
—
728872
BLUE CROSS BLUE SHIELD
GA
Enumeration date
05/02/2006
Last updated
02/10/2017
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