Individual
DR. SUSMITHA PUPPALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2701 N DECATUR RD, DECATUR, GA 30033
(404) 501-5422
(404) 501-1771
Mailing address
2701 N DECATUR RD, DECATUR, GA 30033-5918
(404) 501-5422
(404) 501-1771
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036120875
IL
207R00000X
Internal Medicine Physician
069426
GA
207R00000X
Internal Medicine Physician
MD.30083
AL
208M00000X
Hospitalist Physician
Primary
069426
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
IND NPI / 130250
—
AL
Enumeration date
08/06/2008
Last updated
10/23/2018
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