Organization
ATLANTA VASCULAR AND VEIN CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMISH TILARA MD (PRESIDENT)
(973) 632-8372
Entity
Organization
Contact information
Practice address
600 PROFESSIONAL DR, SUITE 160A, LAWRENCEVILLE, GA 30046-7651
(973) 632-8372
Mailing address
1873 ROYAL TROON CT, DULUTH, GA 30097-5234
(973) 632-2385
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Enumeration date
05/02/2015
Last updated
08/24/2015
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