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NPI Code Detail

MEDICARE: MEDHUB

MEDICARE: MEDHUB
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
1207Q00000XFamily Medicine Physician
2207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1912703166
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDHUB
Provider Business Mailing Address
First Line : 3203 S CHEROKEE LN STE 220
Second Line :
City : WOODSTOCK
State : GA
Zip : 30188-4461
Country : US
Telephone Number : 770-675-6025
Fax Number : 770-676-7814
Provider Business Practice Location Address
First Line : 3203 S CHEROKEE LN STE 220
Second Line :
City : WOODSTOCK
State : GA
Zip : 30188-4461
Country : US
Telephone Number : 770-675-6025
Fax Number : 770-676-7814
Authorized Official
Title or Position : CEO
Name : RAVINDRANATH NALLAMOTHU
Credential : MD
Telephone Number : 770-675-6025
Provider Enumeration Date : 02/19/2025
Last Update Date : 12/08/2025

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Directions to “MEDHUB ” Practice Location

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