Individual
DR. SUJITH KURUVILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1267 HIGHWAY 54 W STE 2200, FAYETTEVILLE, GA 30214-2110
(770) 716-0051
Mailing address
PO BOX 116116, ATLANTA, GA 30368-6116
(605) 990-8975
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
246463-1
NY
207RC0000X
Cardiovascular Disease Physician
246463-1
NY
207RC0000X
Cardiovascular Disease Physician
Primary
85754
GA
Other
Enumeration date
05/15/2009
Last updated
08/06/2020
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