Individual
DR. GANJUR H GURU-PRAKASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
207 HAVEN DR, DOTHAN, AL 36301-2919
(334) 793-3319
(334) 793-2291
Mailing address
207 HAVEN DR, DOTHAN, AL 36301-2919
(334) 793-3319
(334) 793-2291
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
11357
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000089193
—
AL
Enumeration date
10/04/2006
Last updated
03/24/2011
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