Organization
PRASANNA S. SRINAGESH MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRASANNA SRINAGESH MD (PRESIDENT)
(912) 285-2053
Entity
Organization
Contact information
Practice address
220 UVALDA ST, WAYCROSS, GA 31501-4569
(912) 285-2053
(912) 283-5520
Mailing address
PO BOX 1506, WAYCROSS, GA 31502-1506
(912) 285-2053
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
66648
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003112851A
—
GA
Enumeration date
12/01/2017
Last updated
12/01/2017
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