Individual
SARAVANAN KUPPUSWAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 219-8420
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
063594
GA
207R00000X
Internal Medicine Physician
2003012230
MO
207RC0000X
Cardiovascular Disease Physician
Primary
063594
GA
207RC0000X
Cardiovascular Disease Physician
35168
NE
207RC0000X
Cardiovascular Disease Physician
63594
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209236819
—
MO
Enumeration date
04/17/2006
Last updated
09/05/2023
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