Individual
DR. SUNDERRAJ MARK KAMALESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
210 E DERENNE AVE, SAVANNAH, GA 31405-6736
(912) 644-5300
(912) 644-5280
Mailing address
210 E DERENNE AVENUE, SAVANNAH, GA 31405
(912) 644-5300
(912) 644-5260
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
042622
GA
207X00000X
Orthopaedic Surgery Physician
25383
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000732828B
—
GA
Enumeration date
02/10/2006
Last updated
10/24/2019
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