Individual
MR. RAO S MIKKILINENI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
483 UPPER RIVERDALE RD SW, SUITE A, SOUTH ATLANTA PULMONARY & CRITICAL CARE ASS, RIVERDALE, GA 30274-2584
(770) 991-3888
(770) 994-0278
Mailing address
483 UPPER RIVERDALE ROAD, SUITE A, RAI S. MIKKILINENI, M.D., RIVERDALE, GA 30274-2584
(770) 991-3888
(770) 994-0278
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
023852
GA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
GA023852
GA
207RP1001X
Pulmonary Disease Physician
Primary
023852
GA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
GA023852
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00322308A
—
GA
Enumeration date
08/09/2005
Last updated
03/20/2015
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