Organization
MADDINENI HOLDINGS LLC
Active
Other names
HEALTH STAR FAMILY MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
USHA MUSUNURU M.D (OWNER)
(770) 932-7605
Entity
Organization
Contact information
Practice address
4485 TENCH RD, SUITE NO 120, SUWANEE, GA 30024-6739
(770) 932-7605
Mailing address
4485 TENCH RD, SUITE NO 120, SUWANEE, GA 30024-6739
(770) 932-7605
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
055265
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
511G701213
MEDICARE RAILROAD
GA
01
—
APPLIED FOR
MEDICARE NO APPLIED FOR
GA
Enumeration date
07/10/2007
Last updated
03/22/2011
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