Individual
DR. SUMANA MOOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3390 PADDOCKS PKWY STE 100, SUWANEE, GA 30024-9119
(770) 400-0828
(866) 554-1774
Mailing address
3390 PADDOCKS PKWY STE 100, SUWANEE, GA 30024-9119
(770) 400-0828
(866) 554-1774
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
77681
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009420200
—
FL
01
—
14R7E
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/02/2006
Last updated
10/14/2022
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