Individual
DR. PRATHIK MUDALIAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-3220
(706) 721-3873
Mailing address
1120 15TH ST RM BI-2144, AUGUSTA, GA 30912-2700
(706) 721-3873
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
010105
GA
207L00000X
Anesthesiology Physician
Primary
94674
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/25/2018
Last updated
06/13/2023
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