Individual
NIRMALA D AMARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
302 UVALDA ST, WAYCROSS, GA 31501-4551
(912) 285-2519
(912) 284-2482
Mailing address
302 UVALDA ST, WAYCROSS, GA 31501-4551
(912) 285-2519
(912) 284-2482
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
043159
GA
208D00000X
General Practice Physician
Primary
043159
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000802315B
—
GA
Enumeration date
07/11/2006
Last updated
06/24/2015
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