Individual
DR. HARI GOPAL MADICHETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, FCCP, D-ABSM
Contact information
Practice address
604A S 8TH ST, GRIFFIN, GA 30224-4214
(770) 227-1999
Mailing address
604A S 8TH ST, GRIFFIN, GA 30224-4214
(770) 227-1999
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
919846878A
—
GA
Enumeration date
02/15/2006
Last updated
09/21/2012
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