Individual
DR. TERESA KIZHAKETHALAKAL GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
771 OLD NORCROSS RD, SUITE 120, LAWRENCEVILLE, GA 30046-4386
(770) 670-6920
(770) 670-6920
Mailing address
771 OLD NORCROSS RD, SUITE 120, LAWRENCEVILLE, GA 30046-4386
(770) 670-6920
(770) 670-6920
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
67420
GA
207R00000X
Internal Medicine Physician
MD.205568
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003140814B
—
GA
05
—
1894206
—
LA
Enumeration date
07/17/2009
Last updated
10/09/2015
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