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NPI Code Detail

MEDICARE: ARCHNA PODDAR M.D.

MEDICARE: ARCHNA PODDAR M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician50827GA

General Provider Information

NPI Number : 1407845340
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARCHNA PODDAR M.D.
Provider Business Mailing Address
First Line : 2878 FIVE FORKS TRICKUM RD
Second Line : STE 2A
City : LAWRENCEVILLE
State : GA
Zip : 30044-5896
Country : US
Telephone Number : 678-344-8700
Fax Number : 678-344-8600
Provider Business Practice Location Address
First Line : 2878 FIVE FORKS TRICKUM RD
Second Line : STE 2A
City : LAWRENCEVILLE
State : GA
Zip : 30044-5896
Country : US
Telephone Number : 678-344-8700
Fax Number : 678-344-8600
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2005
Last Update Date : 05/06/2013

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