Organization
PRIMARY MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAVI K PASUPULETI (OWENER)
(469) 442-8584
Entity
Organization
Contact information
Practice address
4390 CEDAR BRIDGE WALK, SUWANEE, GA 30024-1323
(469) 442-8584
Mailing address
4390 CEDAR BRIDGE WALK, SUWANEE, GA 30024-1323
(469) 442-8584
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
71848
GA
Other
Enumeration date
07/23/2015
Last updated
07/23/2015
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