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Organization
SUSHRUT LLC
Active
Organization
SUSHRUT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIMISHA TRIVEDI (MD)
(706) 623-0155
Entity
Organization
Contact information
Practice address
3778 HIGHWAY 42, LOCUST GROVE, GA 30248-3632
(678) 610-6649
Mailing address
3778 HIGHWAY 42, LOCUST GROVE, GA 30248-3632
(678) 610-6649
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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