Individual
MR. PRAMOD MATHUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1159 MONTE DR, MARIETTA, GA 30062-2896
(770) 321-6142
(770) 509-5364
Mailing address
1159 MONTE DR, MARIETTA, GA 30062-2896
(770) 321-6142
(770) 509-5364
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
033-R-0094
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
399350114A
—
GA
Enumeration date
12/12/2006
Last updated
07/09/2007
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