Organization
EASTSIDE VASCULAR MEDICINE AND SURGERY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUNAID HUSSAIN MUDALIAR M.D. (PRESIDENT)
(678) 684-1040
Entity
Organization
Contact information
Practice address
1700 TREE LANE RD, SUITE 460, SNELLVILLE, GA 30078-6782
(678) 684-1040
(678) 684-1045
Mailing address
1700 TREE LANE RD, SUITE 460, SNELLVILLE, GA 30078-6782
(678) 684-1040
(678) 684-1045
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
050323
GA
Other
Enumeration date
12/19/2007
Last updated
12/19/2007
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