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Individual

DEBI KUMALA PRASETIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5353 REYNOLDS ST, SAVANNAH, GA 31405-6015
(912) 819-6000
Mailing address
650 WYNDHAM WAY, POOLER, GA 31322-3623
(912) 704-9760

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
11214
GA
367H00000X
Anesthesiologist Assistant

Other

Enumeration date
09/15/2022
Last updated
11/14/2022
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