Provider Demographics
NPI:1699077610
Name:A. DHANDAYUTHAPANI, MD PC
Entity type:Organization
Organization Name:A. DHANDAYUTHAPANI, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARACHELVI
Authorized Official - Middle Name:
Authorized Official - Last Name:DHANDAYUTHAPANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-660-5080
Mailing Address - Street 1:PO BOX 4596
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31914-0596
Mailing Address - Country:US
Mailing Address - Phone:706-660-5080
Mailing Address - Fax:706-256-1030
Practice Address - Street 1:713 20TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-8920
Practice Address - Country:US
Practice Address - Phone:706-660-5080
Practice Address - Fax:706-256-1030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-23
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA52166207RN0300X
ALMD.27736207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty