Organization
FAMILY MEDICAL CLINIC OF LAWRENCEVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRANDATHY RODRIGO MD (BUSINESS OWNER)
(678) 225-5540
Entity
Organization
Contact information
Practice address
2522 CRUSE RD, C-2, LAWRENCEVILLE, GA 30044-2750
(678) 225-5540
(678) 225-5541
Mailing address
2522 CRUSE RD, C-2, LAWRENCEVILLE, GA 30044-2750
(678) 225-5540
(678) 225-5541
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042715
GA
Other
Enumeration date
05/15/2008
Last updated
05/15/2008
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