Individual
NISCHALA DHANEKULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3850 WINDERMERE PKWY STE 105, CUMMING, GA 30041-7033
(678) 455-2800
(770) 888-9998
Mailing address
3850 WINDERMERE PKWY STE 105, CUMMING, GA 30041-7033
(678) 455-2800
(770) 888-9998
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
271987
NY
207R00000X
Internal Medicine Physician
37902
SC
207R00000X
Internal Medicine Physician
Primary
80279
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03757568
—
NY
05
—
379021
—
SC
Enumeration date
07/20/2010
Last updated
08/25/2024
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