Organization
MIDHA MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJU MIDHA M.D. (SOLE MEMBER)
(770) 492-8665
Entity
Organization
Contact information
Practice address
1404 MONTREAL RD, TUCKER, GA 30084
(770) 492-8665
(770) 492-8663
Mailing address
1404 MONTREAL RD, TUCKER, GA 30084
(770) 492-8665
(770) 492-8663
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
GA
Other
Enumeration date
03/24/2011
Last updated
11/03/2020
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