Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 078464 | GA |
NPI | 1013207208 |
---|---|
Provider Name | Dr. Vishnu Choudhary Potini |
First Address | Columbus, GA 31904-6802 |
Second Address | Newark, NJ 07103-2425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2011 |
Last Update Date | 23/08/2017 |