Individual
CHITRA RAMASUBBU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
145 RIVERSTONE TER STE 101, CANTON, GA 30114-5327
(770) 450-4807
Mailing address
145 RIVERSTONE TER STE 101, CANTON, GA 30114-5327
(770) 450-4807
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
067966
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
67966
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
67966
MEDICAL LICENSE
GA
Enumeration date
06/25/2008
Last updated
11/02/2022
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