Leela S. Maxa MD, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

037382 Issued in GA

Legal business name

LEELA S. MAXA MD, LLC

Practice address

311 Philip Blvd
Lawrenceville, GA 30046-8733

Phone

(770) 995-3000

Fax

(770) 995-1427

NPI assigned

May 11, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Leela S Maxa, M.D.

Title

Owner/Physician

Phone

(770) 682-2099

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305072000000",
    "number": "1164714937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 PERIMETER CTR E",
            "address_2": "#500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303462294",
            "telephone_number": "770-682-2099",
            "fax_number": "866-281-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 PHILIP BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468733",
            "telephone_number": "770-995-3000",
            "fax_number": "770-995-1427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEELA S. MAXA MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-11",
        "last_updated": "2011-05-11",
        "status": "A",
        "authorized_official_last_name": "MAXA",
        "authorized_official_first_name": "LEELA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "770-682-2099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "037382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.