Individual
PRASAD S GARIMELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 RIVER PL, BRASELTON, GA 30517
(770) 219-6000
(770) 219-6021
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
(770) 219-8440
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
54144
GA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
54144
GA
207RP1001X
Pulmonary Disease Physician
54144
GA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
54144
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148413324A
—
GA
Enumeration date
12/13/2005
Last updated
10/15/2020
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