Individual
KUSUMA RAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
703 S 9TH ST, GRIFFIN, GA 30224-4820
(770) 227-2727
(770) 227-1276
Mailing address
PO BOX 758, GRIFFIN, GA 30224-0020
(770) 227-2727
(770) 227-1276
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
027146
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00314245A
—
GA
Enumeration date
06/20/2005
Last updated
12/11/2013
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