Individual
DR. SOURENDRA RAUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD FRCSC
Contact information
Practice address
1100 NORTHSIDE FORSYTH DRIVE, SUITE 340, CUMMING, GA 30041
(770) 886-8111
(770) 205-8539
Mailing address
1100 NORTHSIDE FORSYTH DRIVE, SUITE 340, CUMMING, GA 30041
(770) 886-8111
(770) 205-8539
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
065169
GA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
065169
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003100343A
—
GA
05
—
003100434B
—
GA
05
—
003100434C
—
GA
Enumeration date
09/28/2009
Last updated
12/28/2011
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