P Praxis·MD
● Active Type 2 · Organization

Provident Healthcare Llc

Internal Medicine·Marietta, GA· NPI 1154706075 · Enumerated 2015 · 10 years on NPI
Provident Healthcare Llc is 1 of 108 internal medicine organizations in Georgia.
NPI age
10 years
Enumerated 2015-07-21
Primary specialty
Internal Medicine
Plus 2 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Dinavahi
Chief Medical Officer
Last NPPES update
2015-07-22
Source: monthly bulk 2026-05

How this organization compares

Across 108 active internal medicine providers in Georgia.

NPI age
10 years
↓ 8 yr below median
Practice locations
1
0 secondary on file
Subspecialties
2
In the 36% of peers with subspecialties

NPI lifetime · 2015 → 2026

2015-07Enumerated in NPPES
2015 2026

Where they practice

Primary practice location
3505 Lassiter Falls Dr Ne
Marietta, GA 300624199
📞 4149169031
Mailing address
3063 Peachtree Industrial Blvd, Ste 200
Duluth, GA 300978639
📞 6783900120

Authorized official

Lakshman K Dinavahi, MD
Chief Medical Officer
📞 6783900120

Individual providers at this organization

1 individual provider on file at this primary practice address.

Specialties

  • Internal Medicine Primary
    An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the...
    GA license #07088 taxonomy 207RG0300X
  • Internal Medicine
    A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer,...
    GA license #07088 taxonomy 207R00000X
  • Internal Medicine
    An internal medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team...
    GA license #07088 taxonomy 207RH0002X

Practice context

Multi-provider organization. 1 individual provider on file at this primary address.

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How to verify this organization

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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