Individual
ASHISH THEKKEKARA BIJU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2790 GODWIN BLVD STE 355, SUFFOLK, VA 23434-8173
(757) 635-0784
Mailing address
3811 JACKSON SHOALS DR, LAWRENCEVILLE, GA 30044-4065
(678) 619-7860
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/28/2023
Last updated
03/28/2023
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