Individual
DR. LAKSHMIPATHI GUPTA NOMULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD FACP
Contact information
Practice address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-7694
(678) 312-3294
(678) 312-3282
Mailing address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-7694
(678) 312-3273
(678) 312-3282
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01073431A
IN
207R00000X
Internal Medicine Physician
93447
GA
208M00000X
Hospitalist Physician
Primary
93447
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109657400
—
FL
01
—
NO148
FL MEDICARE
FL
Enumeration date
06/18/2011
Last updated
09/20/2023
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