Basic Information
Provider Information
NPI: 1669730412
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: THAMMANA
FirstName: REKHA
MiddleName: V
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3495 PIEDMONT ROAD, NE
Address2: NINE PIEDMONT CENTER
City: ATLANTA
State: GA
PostalCode: 30305
CountryCode: US
TelephoneNumber: 4043647070
FaxNumber:  
Practice Location
Address1: 1000 JOHNSON FERRY ROAD NE
Address2: KAISER PERMANENTE AT NORTHSIDE HOSPITAL
City: ATLANTA
State: GA
PostalCode: 30342
CountryCode: US
TelephoneNumber: 4048518000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/30/2012
LastUpdateDate: 11/12/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/12/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207R00000X073503GAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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