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NPI Code Detail

MEDICARE: ASHOK KUMAR KANUGULA M.D

MEDICARE:   ASHOK KUMAR  KANUGULA  M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician35.126308OH
2390200000XStudent in an Organized Health Care Education/Training ProgramMT200813PA
3207R00000XInternal Medicine Physician88543GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487919908
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHOK KUMAR KANUGULA M.D
Provider Business Mailing Address
First Line : 747 S 8TH ST STE B
Second Line :
City : GRIFFIN
State : GA
Zip : 30224-4884
Country : US
Telephone Number : 470-604-8250
Fax Number : 770-999-2814
Provider Business Practice Location Address
First Line : 747 S 8TH ST STE B
Second Line :
City : GRIFFIN
State : GA
Zip : 30224-4884
Country : US
Telephone Number : 470-604-8250
Fax Number : 770-999-2814
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2012
Last Update Date : 09/09/2021

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Directions to “ ASHOK KUMAR KANUGULA M.D” Practice Location

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