Provider Demographics
NPI:1275949992
Name:RADADIA, KUSHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:KUSHAN
Middle Name:
Last Name:RADADIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1551 JANMAR RD
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-5606
Mailing Address - Country:US
Mailing Address - Phone:678-344-8900
Mailing Address - Fax:678-691-0506
Practice Address - Street 1:11660 ALPHARETTA HWY STE 700
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4956
Practice Address - Country:US
Practice Address - Phone:678-839-9973
Practice Address - Fax:470-427-2013
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA84991208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA84991OtherGA MEDICAL LICENSE