Provider Demographics
NPI:1174036313
Name:DR. C'S ATLANTA VASCULAR CENTER, LLC
Entity Type:Organization
Organization Name:DR. C'S ATLANTA VASCULAR CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:UDAYA
Authorized Official - Middle Name:B
Authorized Official - Last Name:CHINTALAPUDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:470-509-4200
Mailing Address - Street 1:4480 ATLANTA HWY
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-7313
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4480 ATLANTA HWY
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-7313
Practice Address - Country:US
Practice Address - Phone:678-910-7228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-09
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty