Individual
DR. DAVID ROMESH PERSAUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
772 MADDOX DR, STE. 122, EAST ELLIJAY, GA 30540-8196
(706) 635-6898
(706) 635-6888
Mailing address
165 BLUE RIDGE OVERLOOK, BLUE RIDGE, GA 30513-4431
(706) 946-5600
(706) 374-7628
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
70703
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003143127A
—
GA
05
—
1035769
—
LA
01
—
202I087630
MEDICARE PTAN
GA
Enumeration date
05/24/2007
Last updated
01/28/2019
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