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NPI Code Detail

MEDICARE: MISS TANISA CELENE MAHALINGAM CAA

MEDICARE: MISS TANISA CELENE MAHALINGAM CAA
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
1367H00000XAnesthesiologist AssistantGA

General Provider Information

NPI Number : 1639007578
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS TANISA CELENE MAHALINGAM CAA
Provider Business Mailing Address
First Line : 7999 AMAWALK CIR
Second Line :
City : JOHNS CREEK
State : GA
Zip : 30097-1933
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 80 JESSE HILL JR DR SE
Second Line :
City : ATLANTA
State : GA
Zip : 30303-3050
Country : US
Telephone Number : 404-616-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2026
Last Update Date : 05/11/2026

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