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MIDHA MEDICAL CLINIC
NPI 1649579046
Family Medicine in Tucker, GA

Active since March 24, 2011CLIA 11D2023828 · Waiver
1404 MONTREAL RD, TUCKER, GA 30084(770) 492-8665(770) 492-8663 Get Directions Write a Review

NPPES record last updated: November 3, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Midha Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIDHA MEDICAL CLINIC (NPI 1649579046) is a healthcare organization registered as a family medicine in Tucker, Georgia and active in the NPI registry since March 2011. The organization holds a CLIA Waiver certificate valid through May 3, 2027 and lists Raju Midha, Sole Member, as its authorized official.

NPPES Registry Identity

NPI1649579046
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMIDHA MEDICAL CLINIC
Location Address1404 MONTREAL RDTucker, GA 30084
Mailing Address1404 Montreal RdTucker, GA 30084 · (770) 492-8665 · Fax (770) 492-8663
Phone(770) 492-8665
Fax(770) 492-8663
Organization SubpartNo
Authorized OfficialRaju MidhaSole Member · (770) 492-8665
Enumeration DateMarch 24, 2011
Last NPPES UpdateNovember 3, 2020
NPPES CertifiedNovember 2, 2020
✔ NPI 1649579046 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1404 MONTREAL RD, Tucker, GA 30084
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2023828

Midha Medical Clinic · Tucker, GA
Active · expires May 3, 2027
CLIA Number11D2023828
Laboratory TypePhysician Office
Certificate Effective DateMay 4, 2025
Certificate Expiration DateMay 3, 2027
Laboratory DirectorMidha Raju
Laboratory Phone(770) 492-8665
Laboratory LocationMidha Medical Clinic1404 Montreal Road, Tucker, GA 30084
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAJU MIDHA M.D.
Family Medicine
1404 MONTREAL RD
TUCKER, GA 30084
Dekalb County (770) 492-8665

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Midha Medical Clinic's NPI number?

The NPI number for Midha Medical Clinic is 1649579046. It was assigned to this organization in the NPPES registry on March 24, 2011.

Where is Midha Medical Clinic located?

Midha Medical Clinic is located at 1404 Montreal Rd, Tucker, GA 30084. The listed phone number is (770) 492-8665.

What is Midha Medical Clinic's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Midha Medical Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2023828) is associated with this NPI, valid through May 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Midha Medical Clinic was last updated on November 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.