Kukaswadia P.C.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

43997 Issued in GA

Legal business name

KUKASWADIA P.C.

Practice address

4904 Timber Ridge Dr
Suite 305
Douglasville, GA 30135-1828

Phone

(678) 501-5420

NPI assigned

Jul 15, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Mohammad A Kukaswadia, MDNPI 1043394109

Title

Physician

Phone

(678) 501-5420

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohammad Ali Kukaswadia, MD

  • Neurology Physician
  • Douglasville, GA
  • NPI 1043394109
  NPD (past) Authorized official

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326844800000",
    "number": "1548573884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 RIVERTON PARK PL SE",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301265685",
            "telephone_number": "678-501-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4904 TIMBER RIDGE DR",
            "address_2": "SUITE 305",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351828",
            "telephone_number": "678-501-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KUKASWADIA P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-15",
        "last_updated": "2012-01-18",
        "status": "A",
        "authorized_official_last_name": "KUKASWADIA",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "678-501-5420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "43997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000757985L",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• KPC Holding Group Inc
• Lindsey Marie Krempa
• Sylvia Krow, LPC
• KTT Services
• Sierra Kucsera
• Mohammad Ali Kukaswadia, MD
• Raju J Kulangara, MD
• Poonam Kumar
• Surender V Kumar, M.D.
• Veeni S Kumar, M.D.

• Neurology Physician in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Neurology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.