Organization
INFECTIOUS DISEASES & INTERNATIONAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NISHA PANICKER ARAVINDAKSHAN PATEL (CEO/OWNER)
(516) 447-0795
Entity
Organization
Contact information
Practice address
1514 VERNON RD, LAGRANGE, GA 30240-4131
(708) 489-9005
(844) 443-3963
Mailing address
543 WINTON TER NE UNIT A, ATLANTA, GA 30308-2826
(516) 424-0795
(844) 443-3963
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942527478
NPI
GA
Enumeration date
07/08/2021
Last updated
03/23/2022
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