Basic Information
| Provider Information | |||||||||
| NPI: | 1073523247 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ADULLA | ||||||||
| FirstName: | MADHURIMA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 665 DULUTH HWY STE 801 | ||||||||
| Address2: | |||||||||
| City: | LAWRENCEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300468709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4703250148 | ||||||||
| FaxNumber: | 7703390485 | ||||||||
| Practice Location | |||||||||
| Address1: | 665 DULUTH HWY STE 401 | ||||||||
| Address2: | |||||||||
| City: | LAWRENCEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300464303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6783120450 | ||||||||
| FaxNumber: | 7703392135 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2006 | ||||||||
| LastUpdateDate: | 10/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 45830-020 | WI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 057035 | GA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | 57035 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.