Individual
NIKHIL MADALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
169 ASHLEY AVE, CHARLESTON, SC 29425-8905
(214) 609-7433
Mailing address
169 ASHLEY AVE, CHARLESTON, SC 29425-8905
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
95896
GA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/04/2020
Last updated
04/27/2026
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