Provider Demographics
NPI:1205835097
Name:VAYMAN, LYUDMILA (MD)
Entity Type:Individual
Prefix:DR
First Name:LYUDMILA
Middle Name:
Last Name:VAYMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 ROYAL BLVD S
Mailing Address - Street 2:STE 110
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1409
Mailing Address - Country:US
Mailing Address - Phone:770-442-5437
Mailing Address - Fax:770-674-3777
Practice Address - Street 1:3005 ROYAL BLVD S
Practice Address - Street 2:STE 110
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-1409
Practice Address - Country:US
Practice Address - Phone:770-442-5437
Practice Address - Fax:770-674-3777
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA027318208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD31091Medicare UPIN
GA00379266Medicare ID - Type Unspecified