| Kukaswadia P.c. | |
|
4904 Timber Ridge Dr Suite 305 Douglasville GA 30135-1828 | |
| (678) 501-5420 | |
| Not Available |
| Full Name | Kukaswadia P.c. |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 4904 Timber Ridge Dr, Douglasville, Georgia |
| Authorized Official Name and Position | Mohammad A Kukaswadia (PHYSICIAN) |
| Authorized Official Contact | 6785015420 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kukaswadia P.c. 822 Riverton Park Pl Se Mableton GA 30126-5685 Ph: (678) 501-5420 | Kukaswadia P.c. 4904 Timber Ridge Dr Suite 305 Douglasville GA 30135-1828 Ph: (678) 501-5420 |
| NPI Number | 1548573884 |
|---|---|
| Provider Enumeration Date | 07/15/2010 |
| Last Update Date | 01/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548573884 | NPI | - | NPPES |
| 000757985L | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 43997 (Georgia) | Primary |
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