Individual
SUWARO GASSAMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6600 VAN AALST BLVD, FORT BENNING, GA 31905-2102
(762) 408-2273
Mailing address
7338 PINE TAR DR, MIDLAND, GA 31820-1103
(502) 821-0379
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
968354
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
003800
GA
367500000X
Certified Registered Nurse Anesthetist
1207276
TX
Other
Enumeration date
07/10/2025
Last updated
07/22/2025
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