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Individual

AKHIL VALLABHANENI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
460 NORTHSIDE CHEROKEE BLVD STE 130, CANTON, GA 30115-8017
(678) 493-2527
(678) 493-5608
Mailing address
460 NORTHSIDE CHEROKEE BLVD STE 130, CANTON, GA 30115-8017
(678) 493-2527
(678) 493-5608

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
076513
GA
207RP1001X
Pulmonary Disease Physician
MD153603
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500633229
OR
Enumeration date
02/07/2008
Last updated
04/26/2021
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