Individual
SUJA P ANTONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4000 SAINT MARYS RD, COLUMBUS, GA 31907-7626
(706) 685-2770
(706) 685-3299
Mailing address
4000 SAINT MARYS RD, COLUMBUS, GA 31907-7626
(706) 685-2770
(706) 685-3299
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
186261
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP4537
MEDICARE
GA
Enumeration date
07/31/2018
Last updated
07/31/2018
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