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NPI Code Detail

MEDICARE: VSHIELD INFECTIOUS DISEASE LLC

MEDICARE: VSHIELD INFECTIOUS DISEASE LLC
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
1363L00000XNurse Practitioner
2207RI0200XInfectious Disease Physician

General Provider Information

NPI Number : 1497638266
Entity Type Code : Organization
Provider Name (Legal Business Name) : VSHIELD INFECTIOUS DISEASE LLC
Provider Business Mailing Address
First Line : 555 N POINT CTR E FL 4
Second Line :
City : ALPHARETTA
State : GA
Zip : 30022-8269
Country : US
Telephone Number : 802-735-0001
Fax Number : 903-342-8251
Provider Business Practice Location Address
First Line : 1165 SANDERS RD
Second Line :
City : CUMMING
State : GA
Zip : 30041-5965
Country : US
Telephone Number : 802-735-0001
Fax Number :
Authorized Official
Title or Position : MD/OWNER
Name : KISHORE RASAMALLU
Credential :
Telephone Number : 210-379-8553
Provider Enumeration Date : 07/29/2025
Last Update Date : 07/29/2025

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