Nyshadham, Swaroop

Nyshadham, Swaroop is an sole proprietor health care provider with primary practice located at 1990 Lukken Industrial Dr W Suite C, Lagrange GA 30240-1404. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Nyshadham, Swaroop can be contacted via phone (706) 883-8787.

Contact Information

Primary practice address
1990 Lukken Industrial Dr W Suite C Lagrange GA 30240-1404
Phone: (706) 883-8787
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 00013121 Alabama
Allopathic & Osteopathic Physicians / Surgery 208600000X ME 49553 Florida
Allopathic & Osteopathic Physicians / General Practice 208D00000X 031483 Georgia

Profile Details

NPI number 1306892351
LBN Legal business name Nyshadham, Swaroop
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 25th, 2006
Last updated Feb 21st, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306892351 NPPES
Georgia MEDICAID 000338357H

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