Individual
SUBODH K LAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4441 ATLANTA RD SE STE 204, SMYRNA, GA 30080-6442
(678) 741-5000
(770) 739-2318
Mailing address
711 CANTON RD NE, SUITE 300, MARIETTA, GA 30060-8948
(678) 741-5000
(678) 819-4280
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
052771
GA
207RG0100X
Gastroenterology Physician
Primary
052771
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118202729A
—
GA
Enumeration date
02/08/2006
Last updated
08/16/2018
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