Midha Medical Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MIDHA MEDICAL CLINIC

Practice address

1404 Montreal Rd
Tucker, GA 30084

Phone

(770) 492-8665

Fax

(770) 492-8663

NPI assigned

Mar 24, 2011

Organization subpart

No

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

Authorized official

Name

Raju Midha, M.D.NPI 1497745251

Title

Sole Member

Phone

(770) 492-8665

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: raju.midha@gadirect.net

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Raju Midha, M.D.

  • Family Medicine Physician
  • Tucker, GA
  • NPI 1497745251
  Medicare reassignment NPD Authorized official
• Nia Charnice Griffin, NP

  • Family Nurse Practitioner
  • Tucker, GA
  • NPI 1144820614
  NPD
• Inuka Midha, PHD MPH MCHES CDCES

  • Health Educator
  • Tucker, GA
  • NPI 1073028676
  NPD

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1649579046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 MONTREAL RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "30084",
            "telephone_number": "770-492-8665",
            "fax_number": "770-492-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 MONTREAL RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "30084",
            "telephone_number": "770-492-8665",
            "fax_number": "770-492-8663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDHA MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-24",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "MIDHA",
        "authorized_official_first_name": "RAJU",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "770-492-8665",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Metro Therapy Providers, Inc
• Metro Therapy Providers, Inc Adults
• Michael Bailey Associates LLC
• Robert James Michelich, D.D.S.
• Bridgette Michelin, PA-C
• Inuka Midha, PHD MPH MCHES CDCES
• Raju Midha, M.D.
• Laura L. Mika, LMSW
• Mike Berry's Opticians Inc.
• Corinne D. Miller, OT

• Family Medicine Physician in Tucker, GA
• Providers in Tucker, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.