Individual
DR. SURAJ SUKUMARAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1067 PEACHTREE ST, LOUISVILLE, GA 30434-1558
(478) 625-7000
(478) 625-8907
Mailing address
1067 PEACHTREE ST, LOUISVILLE, GA 30434-1558
(478) 625-7000
(478) 625-8907
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
044598
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000800357A
—
GA
Enumeration date
07/31/2006
Last updated
09/22/2020
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