Individual
AJAY PREMKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
21 ORTHO LN, ATLANTA, GA 30329-2315
(678) 336-6928
Mailing address
21 ORTHO LN, ATLANTA, GA 30329-2315
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
91707
GA
Other
Enumeration date
04/03/2016
Last updated
08/09/2022
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