| Vital Neurology Llc | |
|
1165 Sanders Rd Cumming GA 30041-5965 | |
| (802) 735-0001 | |
| Not Available |
| Full Name | Vital Neurology Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 1165 Sanders Rd, Cumming, Georgia |
| Authorized Official Name and Position | Kishore Rasamallu (MD/OWNER) |
| Authorized Official Contact | 2103798553 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Neurology Llc 410 Peachtree Pkwy Ste 4245 Cumming GA 30041-7407 Ph: (802) 735-0001 | Vital Neurology Llc 1165 Sanders Rd Cumming GA 30041-5965 Ph: (802) 735-0001 |
| NPI Number | 1629951397 |
|---|---|
| Provider Enumeration Date | 07/29/2025 |
| Last Update Date | 07/29/2025 |
| Certification Date | 07/29/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629951397 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
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