Individual
DR. RADHIKA MUDIYALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3606 HIGHLANDS PKWY SE, BLDG # 1, SMYRNA, GA 30082-5184
(678) 303-5082
(678) 303-5160
Mailing address
3606 HIGHLANDS PKWY SE, BLDG # 1, SMYRNA, GA 30082-5184
(678) 303-5082
(678) 303-5160
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
051069
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109113329A
—
GA
Enumeration date
05/25/2006
Last updated
08/12/2009
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