Individual
DR. SUMANTH R DARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1120 15TH STREET, AUGUSTA, GA 30912-0004
(706) 724-6100
Mailing address
1499 WALTON WAY, SUITE 1400, AUGUSTA, GA 30901-2603
(706) 724-6100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
46290-020
WI
207RG0100X
Gastroenterology Physician
036.130180
IL
207RG0100X
Gastroenterology Physician
Primary
067892
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34565300
—
WI
Enumeration date
01/19/2006
Last updated
09/09/2014
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