Healthcare Provider Details

I. General information

NPI: 1477589125
Provider Name (Legal Business Name): GURUDATT K SETTY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

743 SPRING ST NE
GAINESVILLE GA
30501-3715
US

IV. Provider business mailing address

1488 JESSE JEWELL PKWY SE STE 201
GAINESVILLE GA
30501-3804
US

V. Phone/Fax

Practice location:
  • Phone: 770-532-7179
  • Fax:
Mailing address:
  • Phone: 770-532-7179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number049094
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number049094
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: