Individual
DR. JUNAID HUSSAIN MUDALIAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20 GLENLAKE PKWY, KAISER PERMANENTE GLENLAKE MEDICAL CENTER, ATLANTA, GA 30328-3473
(678) 684-1040
(678) 684-1045
Mailing address
3495 PIEDMONT RD NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1717
(404) 364-7070
(678) 684-1045
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
050323
GA
2086S0129X
Vascular Surgery Physician
Primary
050323
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000913019C
—
GA
Enumeration date
03/02/2006
Last updated
01/13/2022
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