Provider Demographics
NPI:1568748978
Name:AIYAN DIABETES CENTER, LLC
Entity Type:Organization
Organization Name:AIYAN DIABETES CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANAKI
Authorized Official - Middle Name:
Authorized Official - Last Name:NADARAJAH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:706-868-0319
Mailing Address - Street 1:462 FURYS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907
Mailing Address - Country:US
Mailing Address - Phone:706-868-0319
Mailing Address - Fax:706-868-3719
Practice Address - Street 1:462 FURYS FERRY RD
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907
Practice Address - Country:US
Practice Address - Phone:706-868-0319
Practice Address - Fax:706-868-3719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-30
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty