Individual
VIMLA R MAIKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
830 EAGLES LANDING PARKWAY, STOCKBRIDGE, GA 30281-7366
(404) 778-6886
Mailing address
101 W PONCE DELEON, ROOM 331, DECATUR, GA 30030-2542
(404) 778-5000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
004352
GA
363AM0700X
Medical Physician Assistant
Primary
004352
GA
363AM0700X
Medical Physician Assistant
4352
GA
Other
Enumeration date
05/10/2007
Last updated
02/12/2014
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