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Individual

HIRA KOHLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
771 OLD NORCROSS RD, SUITE 255, LAWRENCEVILLE, GA 30046-4386
(770) 963-2967
(770) 339-4585
Mailing address
771 OLD NORCROSS RD, SUITE 255, LAWRENCEVILLE, GA 30046-4386
(770) 963-2967
(770) 339-4585

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
060290
GA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
060290
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003103930A
GA
05
003103930B
GA
05
003103930C
GA
Enumeration date
02/09/2007
Last updated
09/22/2020
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