Individual
SWAPNA MADHAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
260 ELM ST, CUMMING, GA 30040-2467
(770) 887-1668
(779) 781-9937
Mailing address
PO BOX 307, CUMMING, GA 30028-0307
(770) 887-1668
(778) 781-9937
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
057098
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057098
GA MEDICAL LICENSE
GA
01
—
983802
BLUE CORSS/BLUE SHIELD #
GA
Enumeration date
05/22/2006
Last updated
03/07/2023
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