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Individual

MR. SUHAS GANGADHARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
740 S LIMESTONE, STE B101, LEXINGTON, KY 40536
(859) 323-5661
(859) 323-6411
Mailing address
17 DAVIS BLVD., SUITE 308, TAMPA, FL 33606
(813) 250-2506

Taxonomy

Speciality
Code
Description
License number
State
2084V0102X
Vascular Neurology Physician
Primary
54544
KY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/07/2015
Last updated
05/14/2021
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