Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Eastside Vascular Medicine and Surgery, PC

Organization Specialist · NPI 1861676306

Eastside Vascular Medicine and Surgery, PC provides Specialist services in Snellville, Georgia. Licensed in Georgia. Registered with an NPI since 2007.

Licensed in
GA
In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1700 Tree Lane Rd Ste 460
Snellville, GA 30078-6782 Not confirmed with CMS for 18 years — call before visiting
Phone: (678) 684-1040
Fax: (678) 684-1045
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 050323 (GA)

Record details

NPI number1861676306
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Junaid Mudaliar — President · (678) 684-1040
NPI enumeratedDecember 19, 2007
Last updated in NPPESDecember 19, 2007
Mailing address1700 Tree Lane Rd, Suite 460, Snellville, GA 30078-6782

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