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Organization

INNOVMD LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. AMARABALAN RAJENDRAN MD (PRESIDENT)
(516) 301-8155
Entity
Organization

Contact information

Practice address
304 TURNER MCCALL BLVD SW, ROME, GA 30165-5621
(516) 301-8155
Mailing address
3 CENTRAL PLZ # 353, ROME, GA 30161-3233
(516) 301-8155
(404) 393-5986

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2248
MEDICARE PTAN
GA
01
DZ3314
RRMEDICARE PTAN
GA
Enumeration date
04/04/2019
Last updated
09/27/2019
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