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

Mithilesh Siddu

Individual provider Vascular Neurology Physician · NPI 1174907521

Mithilesh Siddu is a Neurology in Augusta, Georgia. Qualified in 2010, 16 years ago. Practices with The Emory Clinic Inc, a 3,500-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
16
Licensed in
GA
In the registry since
2015
Specialties on file
2

Practice location Address checks out

1120 15th St
Augusta, GA 30912-3201
Phone: (706) 721-1962
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X · Licence 83992 (GA)
Vascular Neurology Physician Taxonomy 2084V0102X · Licence 83992 (GA)

Record details

NPI number1174907521
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 15, 2015
Last updated in NPPESJune 20, 2023
Certification dateJune 20, 2023
Mailing address409 Pottery Dr, Martinez, GA 30907-9295

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEUROLOGY
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice The Emory Clinic Inc — 3500 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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