MEDICARE: AMILIA JEYACHANDRAN 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
1	207R00000X	Internal Medicine Physician	109988	GA

General Provider Information

NPI Number	:	1710629217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMILIA JEYACHANDRAN MD

Provider Business Mailing Address
First Line	:	3699 CASCADE RD SW # B2
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-2163
Country	:	US
Telephone Number	:	404-691-7006
Fax Number	:	404-691-4609

Provider Business Practice Location Address
First Line	:	3699 CASCADE RD SW STE B2
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-2163
Country	:	US
Telephone Number	:	404-691-7006
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2022
Last Update Date	:	02/06/2026

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