Individual
KSHITIJ VIPIN MAJMUNDAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1360 UPPER HEMBREE RD, SUITE 201, ROSWELL, GA 30076-1146
(770) 475-3361
(770) 664-4431
Mailing address
PO BOX 933087, ATLANTA, GA 31193-3087
(770) 475-3361
(770) 664-4431
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
57545
GA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
57545
GA
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
57545
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57545
MEDICAL LICENSE
GA
Enumeration date
02/08/2007
Last updated
03/18/2008
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