Healthcare Provider Details

I. General information

NPI: 1114045770
Provider Name (Legal Business Name): VAISHALI B KUTE, MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 05/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3155 N POINT PKWY BUILDING D SUITE 200
ALPHARETTA GA
30005-5481
US

IV. Provider business mailing address

3155 N POINT PKWY BUILDING D SUITE 200
ALPHARETTA GA
30005-5481
US

V. Phone/Fax

Practice location:
  • Phone: 770-667-6967
  • Fax:
Mailing address:
  • Phone: 770-667-6967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number045526
License Number StateGA

VIII. Authorized Official

Name: DR. VAISHALI B KUTE
Title or Position: PRESIDENT
Credential: MD
Phone: 770-667-6967