Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 068790 | GA |
NPI | 1063520419 |
---|---|
Provider Name | Rajinikanth Seshan |
First Address | Riverdale, GA 30274-4945 |
Second Address | Riverdale, GA 30274-4945 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2006 |
Last Update Date | 29/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003144035A | (05) | GA |