Basic Information
| Provider Information | |||||||||
| NPI: | 1982992293 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DASWATTA | ||||||||
| FirstName: | DILINI | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | D.O | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1365 CLIFTON RD NE STE 6100 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303220001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047279934 | ||||||||
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| Practice Location | |||||||||
| Address1: | 595 HURRICANE SHOALS RD NW STE 100 | ||||||||
| Address2: | |||||||||
| City: | LAWRENCEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4046457150 | ||||||||
| FaxNumber: | 6789905259 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2011 | ||||||||
| LastUpdateDate: | 07/24/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 5101019583 | MI | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 5101019583 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | 78010 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.