Provider Demographics
NPI:1417101189
Name:RONDLA, CHETANA (MD)
Entity Type:Individual
Prefix:DR
First Name:CHETANA
Middle Name:
Last Name:RONDLA
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 1:595 HURRICANE SHOALS ROAD, N.W.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-8762
Mailing Address - Country:US
Mailing Address - Phone:404-645-7150
Mailing Address - Fax:404-645-7107
Practice Address - Street 1:595 HURRICANE SHOALS ROAD, N.W.
Practice Address - Street 2:SUITE 100
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046
Practice Address - Country:US
Practice Address - Phone:404-645-7150
Practice Address - Fax:404-645-7107
Is Sole Proprietor?:No
Enumeration Date:2008-11-07
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA71626207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology