Individual
DR. SUCHETA GUPTA GARG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
417 W 3RD AVE, ALBANY, GA 31701-1943
(229) 317-2207
(229) 317-2214
Mailing address
PO BOX 408, ALBANY, GA 31702-0408
(205) 437-6098
(205) 437-5998
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
038492
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000606845N
—
GA
05
—
000606845O
—
GA
01
—
364837
WELLCARE
GA
01
—
52576277009
BCBS
GA
01
—
P00287114
RAILRAOD MEDICARE
GA
Enumeration date
09/20/2005
Last updated
07/12/2007
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