Individual
DR. AVANTHIKA THANUSHI WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5665 PEACHTREE DUNWOODY RD, ATLANTA, GA 30342-1764
(678) 843-6497
Mailing address
5665 PEACHTREE DUNWOODY RD, ATLANTA, GA 30342-1764
(678) 843-6497
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
275177
NY
207RP1001X
Pulmonary Disease Physician
Primary
79142
GA
208M00000X
Hospitalist Physician
275177
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01131126/RGH
—
NY
05
—
03007063/NWK
—
NY
05
—
03007072/OPD
—
NY
Enumeration date
07/27/2011
Last updated
06/10/2019
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