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NPI Code Detail

MEDICARE: MRS. PUSHPA LALAJI MD

MEDICARE: MRS. PUSHPA LALAJI MD
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
1207V00000XObstetrics & Gynecology Physician64585GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
164585OTHERGALICENSE

General Provider Information

NPI Number : 1013918721
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PUSHPA LALAJI MD
Provider Business Mailing Address
First Line : 2878 FIVE FORKS TRICKUM RD
Second Line : 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 : 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 : 08/03/2005
Last Update Date : 06/26/2012

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