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Individual

PRASHANTH THALANAYAR MUTHUKRISHNAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6095 PROFESSIONAL PKWY STE A200, DOUGLASVILLE, GA 30134-5606
(770) 422-1372
(770) 999-2611
Mailing address
6095 PROFESSIONAL PKWY STE A200, DOUGLASVILLE, GA 30134-5606
(770) 422-1372
(770) 999-2611

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
293615-1
NY
207RP1001X
Pulmonary Disease Physician
Primary
29698
WV

Other

Enumeration date
08/31/2012
Last updated
08/07/2025
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