Healthcare Provider Details

I. General information

NPI: 1114863792
Provider Name (Legal Business Name): FNU AAYUSH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

INTERNAL MEDICINE CLINIC 1432 BROADRICK DRIVE
DALTON GA
30720
US

IV. Provider business mailing address

1200 MEMORIAL DRIVE, HAMILTON MEDICAL CENTER
DALTON GA
30720
US

V. Phone/Fax

Practice location:
  • Phone: 706-226-8990
  • Fax: 706-529-5317
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: