Doctor Name: | NIRAJ KHANDELWAL |
NPI Number: | 1619186228 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD, MHS |
License Number: | |
Business Practice Address: | 1265 Highway 54 W Suite 402 Fayetteville, GA - 302144548 |
Business Phone Number: | 7707193240 |
Business Fax Number: | 7707193241 |
Mailing Address: | 95 Collier Rd Nw, Suite 4075 ATLANTA |
State: | GA |
Postal Code: | 303091796 |
Phone Number: | 4043553200 |
Fax Number: | 4043559316 |
NPI Enumeration Date: | 05/21/2007 |
NPI Last Update Date: | 07/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |