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General NPI Number Information
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NPI Number | 1437346384
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Entity Type | Organization
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Legal Business Name | SWARNALATHA INDERJITH.MD.PC
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 09/25/2007
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Provider Practice Location Address
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Address Line | 2365 HIGHWAY 92 #110
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City | ACWORTH
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State | GA
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Zip | 30102-7712
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Country | US
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Telephone | 770-917-1050
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Fax | 770-917-0301
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Provider Business Mailing Address
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Address Line | PO BOX 1192
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City | WOODSTOCK
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State | GA
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Zip | 30188-1192
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Country | US
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Telephone | 770-917-1050
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Fax | 770-917-0301
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SWARNALATHA INDERJITH
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Credential | M.D
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Telephone | 770-917-1050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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