GWINNETT DIGESTIVE CLINIC PC NPI 1497898381

NPI Information

  • NPI: 1497898381
  • Provider Name: GWINNETT DIGESTIVE CLINIC, PC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • CLIA Number: 11D2277856
  • Address: 475 PHILIP BLVD
    SUITE 304
    LAWRENCEVILLE, GA
    ZIP 30045
  • Phone: (678) 377-8252

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NPI Details

GWINNETT DIGESTIVE CLINIC, PC is a specialist in Lawrenceville, GA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. GWINNETT DIGESTIVE CLINIC, PC NPI is 1497898381. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

475 PHILIP BLVD
SUITE 304
LAWRENCEVILLE, GA
ZIP 30045-732
Phone: (678) 377-8252
Fax: (770) 963-0122

The provider's authorized official is Bhuvanendram Indrakrishnan .
The authorized official title is Md and has the following contact phone number (678) 377-8252.

The CLIA number assigned to this NPI record is 11D2277856 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/14/2007 and was last updated on 1/11/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist042289GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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