Individual
DR. VITALIY D GAVRIKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1365 CLIFTON ROAD, NE, SUITE AT635, ATLANTA, GA 30322
(404) 778-2650
(404) 778-4296
Mailing address
1365 CLIFTON RD NE, SUITE AT635, ATLANTA, GA 30322-1013
(404) 778-2650
(404) 778-4296
Taxonomy
Speciality
Code
Description
License number
State
207UN0902X
Nuclear Imaging & Therapy Physician
Primary
061430
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568671444
—
GA
Enumeration date
05/21/2007
Last updated
08/12/2008
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