Individual
VAJRESHWARI SHIVAPRAKASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2525 CUMBERLAND PARKWAY, ATLANTA, GA 30339
(404) 606-0122
Mailing address
3495 PIEDMONT ROAD, NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305
(404) 364-7000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
052095
GA
207RN0300X
Nephrology Physician
052095
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
387753465A
—
GA
Enumeration date
07/12/2006
Last updated
02/09/2022
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