Individual
PRATHYUSHA MIDIDODDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3685 LAWRENCEVILLE HWY STE 100, LAWRENCEVILLE, GA 30044-4152
(770) 921-7386
Mailing address
3685 LAWRENCEVILLE HWY STE 100, LAWRENCEVILLE, GA 30044-4152
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
77878
GA
Other
Enumeration date
06/23/2014
Last updated
04/04/2018
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