Individual
SUDHAKAR JONNALAGADDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 SHIRLEY AVE, DOUGLAS, GA 31533-2332
(912) 384-7275
(912) 384-4343
Mailing address
300 SHIRLEY AVE, DOUGLAS, GA 31533-2332
(912) 384-7275
(912) 384-4343
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
041589
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000831784A
—
GA
Enumeration date
08/25/2005
Last updated
05/12/2022
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