Individual
KARTHIKEYAN PONNUSAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1505 STONE BRIDGE PKWY STE 200, WOODSTOCK, GA 30189-8282
(770) 926-9112
(770) 926-8240
Mailing address
1505 STONE BRIDGE PKWY STE 200, WOODSTOCK, GA 30189-8282
(770) 926-9112
(770) 926-8240
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
110573
ZZ
207X00000X
Orthopaedic Surgery Physician
27416
WV
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
77758
GA
Other
Enumeration date
04/19/2011
Last updated
02/15/2024
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