Healthcare Provider Details

I. General information

NPI: 1215043278
Provider Name (Legal Business Name): KALAI C PARTHIBAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 COLLIER RD NW STE 635
ATLANTA GA
30309
US

IV. Provider business mailing address

2727 PACES FERRY RD SE STE 1-1100
ATLANTA GA
30339-6151
US

V. Phone/Fax

Practice location:
  • Phone: 404-367-3014
  • Fax:
Mailing address:
  • Phone: 470-271-3418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number055500
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: