| Doctor Name: | DR. JUNAID HUSSAIN MUDALIAR |
| NPI Number: | 1215904834 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 050323 |
| Business Practice Address: | 20 Glenlake Parkway Kaiser Permanente Glenlake Medical Center Atlanta, GA - 30328 |
| Business Phone Number: | 6786841040 |
| Business Fax Number: | 6786841045 |
| Mailing Address: | 3495 Piedmont Road, Ne, Nine Piedmont Center ATLANTA |
| State: | GA |
| Postal Code: | 30305 |
| Phone Number: | 4043647070 |
| Fax Number: | 6786841045 |
| NPI Enumeration Date: | 03/02/2006 |
| NPI Last Update Date: | 04/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 050323 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |