Individual
SOUMYAA THUSHYANTHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2212
(404) 686-4411
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-9740
(704) 384-9565
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-10363
NC
363A00000X
Physician Assistant
Primary
11854
GA
363A00000X
Physician Assistant
—
—
Other
Enumeration date
06/17/2020
Last updated
09/17/2023
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