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Individual

DR. GANESHA B. PERERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4040 HIGHWAY 17 UNIT 306, MURRELLS INLET, SC 29576-5098
(843) 792-1414
Mailing address
PO BOX 1524, AUGUSTA, GA 30903-1524
(706) 774-7263
(706) 774-7230

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
060964
GA
2086S0129X
Vascular Surgery Physician
Primary
31463
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
029
TRICARE
SC
01
067
BLUE CHOICE
SC
01
224310
MEDCOST
SC
01
AA46098552
MEDICARE PTAN
SC
05
G60964
SC
Enumeration date
11/15/2006
Last updated
10/17/2025
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