Individual
SEARLE VIDELEFSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
755 WALTHER RD, LAWRENCEVILLE, GA 30046
(770) 962-0399
Mailing address
755 WALTHER RD, LAWRENCEVILLE, GA 30046-8725
(770) 962-0399
(770) 995-0533
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
42477
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000720519A
—
GA
Enumeration date
08/08/2006
Last updated
07/16/2021
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