Organization
LIVINGSTONE A. RASALAM, M.D. P.C.
Active
Parent organization
LIVINGSTONE A. RASALAM, M.D., P.C.
Other names
Pathway Wellness Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIVINGSTONE A. RASALAM, M.D., P.C.
Authorized official
LIVINGSTONE AJIT RASALAM M.D.,P.C. (MEDICAL DIRECTOR/OWNER)
(229) 244-5000
Entity
Organization
Contact information
Practice address
303 WOODROW WILSON DR, VALDOSTA, GA 31602-2537
(229) 244-5000
(229) 244-0808
Mailing address
3338L COUNTRY CLUB DR. STE. 1 PMB 150, VALDOSTA, GA 31605
(229) 244-8288
(775) 459-9129
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
033437
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00475208C
—
GA
Enumeration date
06/10/2006
Last updated
08/01/2008
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