Healthcare Provider Details
I. General information
NPI: 1225184658
Provider Name (Legal Business Name): GUNA P SEKAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/26/2007
Last Update Date: 11/19/2020
Certification Date: 11/19/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
555 OLD NORCROSS RD STE 210
LAWRENCEVILLE GA
30046-8716
US
IV. Provider business mailing address
PO BOX 116156
ATLANTA GA
30368-6156
US
V. Phone/Fax
- Phone: 678-312-5250
- Fax: 678-442-7648
- Phone: 470-325-0100
- Fax: 470-325-0193
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 53376 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: