Mahathre, Vijay K.

Mahathre, Vijay K. is an individual health care provider with primary practice located at 163 S Tallahassee St , Hazlehurst GA 31539-6465. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Mahathre, Vijay K. can be contacted via phone (912) 375-7781.

Contact Information

Primary practice address
163 S Tallahassee St Hazlehurst GA 31539-6465
Phone: (912) 375-7781
Fax: (912) 375-4055
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 041612 Georgia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 41612 Georgia

Profile Details

NPI number 1528047016
LBN Legal business name Mahathre, Vijay K.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 12th, 2006
Last updated Dec 11th, 2019 - about 5 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 1528047016 NPPES
Georgia Other 52581283022 BLUECROSS BLUESHIELD
Georgia MEDICAID 000721201S BLUECROSS BLUESHIELD

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