Individual
SUNIL TERRY PERSAUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2406 BEMISS RD, SUITE C, VALDOSTA, GA 31602-1997
(229) 293-9555
(229) 293-9557
Mailing address
4060 KILARNEY CIR, VALDOSTA, GA 31602-0815
(229) 293-9555
(229) 293-9557
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
048175
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
ME0061636
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00891404A
—
GA
Enumeration date
02/23/2007
Last updated
07/08/2007
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