Provider Demographics
NPI:1811935117
Name:WASHINGTON, TANDUA O (MD)
Entity type:Individual
Prefix:
First Name:TANDUA
Middle Name:O
Last Name:WASHINGTON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:TANDUA
Other - Middle Name:O
Other - Last Name:COLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3495 PIEDMONT RD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1773
Mailing Address - Country:US
Mailing Address - Phone:404-364-7000
Mailing Address - Fax:
Practice Address - Street 1:85 RICHLAKE DR STE 350
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-4315
Practice Address - Country:US
Practice Address - Phone:404-949-5019
Practice Address - Fax:979-256-0862
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA053076208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA274383052HMedicaid