Provider Demographics
NPI:1598181943
Name:NATH, VIKAS (MD)
Entity Type:Individual
Prefix:
First Name:VIKAS
Middle Name:
Last Name:NATH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 741087
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-1087
Mailing Address - Country:US
Mailing Address - Phone:478-464-5567
Mailing Address - Fax:478-751-0455
Practice Address - Street 1:200 INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-2981
Practice Address - Country:US
Practice Address - Phone:478-274-3825
Practice Address - Fax:478-274-3254
Is Sole Proprietor?:No
Enumeration Date:2014-03-10
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.141954207ZP0102X
GA90143207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology