Prathyusha Mididoddi
Pediatrics in Lawrenceville, GA. Individual provider (NPI-1).
NPI number1669887196
StatusActive
Last updated in NPPESApr 4, 2018
Details
- NPI
- 1669887196
- Entity type
- Individual (NPI-1)
- Name
- Prathyusha Mididoddi
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 23, 2014
- Last updated
- Apr 4, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | 77878 | GA | Yes |
Practice location
3685 Lawrenceville Hwy Ste 100Lawrenceville, GA 30044-4152
Phone 770-921-7386
Mailing address
3685 Lawrenceville Hwy Ste 100Lawrenceville, GA 30044-4152
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