Immaneni, Supriya
Immaneni, Supriya is an individual health care provider with primary practice located at 308 Coliseum Dr St 200, Macon GA 31217-3865. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Immaneni, Supriya can be contacted via phone (478) 742-2180.Contact Information
Primary practice address
308 Coliseum Dr St 200
Macon GA 31217-3865
Phone: (478) 742-2180
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 95284 | Georgia |
Profile Details
| NPI number | 1497129399 |
|---|---|
| LBN Legal business name | Immaneni, Supriya |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 17th, 2015 |
| Last updated | Jan 2nd, 2024 - about 10 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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