Individual
DR. SUSHANTH RAGHU BODA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3231 HIGHWAY 34 E STE C, NEWNAN, GA 30265-6407
(678) 971-4167
Mailing address
3231 HIGHWAY 34 E STE C, NEWNAN, GA 30265-6407
(678) 971-4167
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
125071636
IL
207L00000X
Anesthesiology Physician
271781
MA
207LP2900X
Pain Medicine (Anesthesiology) Physician
92204
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
92204
GA
Other
Enumeration date
06/19/2017
Last updated
10/31/2025
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