Individual
DR. PRASANNA SAMPURNA SRINAGESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
220 UVALDA ST, WAYCROSS, GA 31501-4569
(912) 285-2053
Mailing address
824 SAINT MARYS DR, WAYCROSS, GA 31501-3245
(347) 804-4230
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
046093
CT
207RN0300X
Nephrology Physician
Primary
66648
GA
208M00000X
Hospitalist Physician
046093
CT
Other
Enumeration date
01/15/2008
Last updated
11/07/2012
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