Individual
SUSEELA VAJRAKARUR
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
1915 EISENHOWER DR, SAVANNAH, GA 31406-5027
(912) 356-2011
(912) 351-3538
Mailing address
1915 EISENHOWER DR, SAVANNAH, GA 31406-5027
(912) 356-2011
(912) 351-3538
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
028662
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028662
LICENSE
GA
Enumeration date
04/21/2006
Last updated
07/08/2007
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