Individual
BARATH PRASHANTH SIVASUBRAMANIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
743 SPRING ST NE REAR 710, GAINESVILLE, GA 30501-3899
(770) 219-8730
Mailing address
743 SPRING ST NE REAR 710, GAINESVILLE, GA 30501-3899
(770) 219-8730
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16578
GA
Other
Enumeration date
06/06/2024
Last updated
06/26/2024
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