Provider Demographics
NPI:1073731428
Name:LALL, THOMAS RAMDHANIE (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:RAMDHANIE
Last Name:LALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3144 TOWERVIEW DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-2539
Mailing Address - Country:US
Mailing Address - Phone:313-575-7445
Mailing Address - Fax:
Practice Address - Street 1:285 BOULEVARD NE STE 525
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-4211
Practice Address - Country:US
Practice Address - Phone:404-265-1044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2023-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA70138207R00000X
MI4301088005207R00000X
GA070138207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine