SUPRIYA IMMANENI

MACON, GA
NPI1497129399
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207N00000X Dermatology
(Licence: GA  95284)
Enumeration Date2015-11-17
Last Update Date2024-01-02
Business Address
SUPRIYA IMMANENI MD
308 COLISEUM DR ST 200
MACON, GA 31217-3865
Phone number: 478-742-2180
Mailing Address
SUPRIYA IMMANENI MD
308 COLISEUM DR ST 200
MACON, GA 31217-3865
Phone number: 478-742-2180
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