Individual
PRAMODINI K GOSUKONDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
777 HEMLOCK ST, MACON, GA 31201-2102
(478) 633-7550
(478) 633-3235
Mailing address
5410 MARYLAND WAY, SUITE 300, BRENTWOOD, TN 37027-5064
(615) 377-5670
(615) 377-1678
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
056558
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11SCFVX
—
GA
Enumeration date
12/20/2006
Last updated
03/21/2008
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