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General NPI Number Information
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NPI Number | 1881066504
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Entity Type | Organization
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Legal Business Name | SURESH PERSAD MD PC
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Dates
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Enumeration Date | 10/21/2015
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Last Update Date | 11/23/2015
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Provider Practice Location Address
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Address Line | 361 COMMERCIAL DR SUITE B
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City | SAVANNAH
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State | GA
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Zip | 31406-3659
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Country | US
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Telephone | 912-352-7936
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Fax | 912-352-0079
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Provider Business Mailing Address
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Address Line | 361 COMMERCIAL DR SUITE B
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City | SAVANNAH
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State | GA
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Zip | 31406-3659
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Country | US
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Telephone | 912-352-7936
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Fax | 912-352-0079
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MS. MARY N NWOSU
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Credential |
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Telephone | 912-352-7936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
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License Number | 17717
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License Number State | GA
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