Provider Demographics
NPI:1235515321
Name:LALIKAN MED LLC
Entity Type:Organization
Organization Name:LALIKAN MED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SYAMALA
Authorized Official - Middle Name:DEVI
Authorized Official - Last Name:ERRAMILLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-860-5416
Mailing Address - Street 1:5944 NORFOLK CHASE RD
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-3516
Mailing Address - Country:US
Mailing Address - Phone:678-860-5415
Mailing Address - Fax:678-971-2020
Practice Address - Street 1:2926 MOUNTAIN INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-3012
Practice Address - Country:US
Practice Address - Phone:678-860-5415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA47896207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty