Individual
DR. AMISH TILARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 PROFESSIONAL DR, SUITE 160A, LAWRENCEVILLE, GA 30046-7651
(973) 632-8372
Mailing address
1873 ROYAL TROON CT, DULUTH, GA 30097-5234
(973) 632-8372
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
72836
GA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
72836
GA
Other
Enumeration date
03/14/2010
Last updated
09/19/2015
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