Individual
PRABHAKAR MITHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1336 HIGHWAY 54 W BLDG 200, FAYETTEVILLE, GA 30214-4574
(770) 460-9777
Mailing address
1930 BRANNAN RD, MCDONOUGH, GA 30253-4310
(678) 284-4040
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
89259
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2014
Last updated
06/15/2021
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