Supriya Immaneni, MD | |
308 Coliseum Dr, St 200, Macon, GA 31217-3865 | |
(478) 742-2180 | |
Not Available |
Full Name | Supriya Immaneni |
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Gender | Female |
Speciality | Dermatology |
Location | 308 Coliseum Dr, Macon, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1497129399 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207N00000X | Dermatology | 95284 (Georgia) | Primary |
Entity Name | Skin Care Physicians Of Georgia, P.c.. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1346351582 PECOS PAC ID: 7517850712 Enrollment ID: O20040203000364 |
Mailing Address | Practice Location Address |
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Supriya Immaneni, MD 308 Coliseum Dr, St 200, Macon, GA 31217-3865 Ph: (478) 742-2180 | Supriya Immaneni, MD 308 Coliseum Dr, St 200, Macon, GA 31217-3865 Ph: (478) 742-2180 |
Virginia Childs Hall, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 520 Charter Blvd, Suite 100, Macon, GA 31210 Phone: 478-477-6700 Fax: 478-757-8135 | |
Dr. Judah Norman Greenberg, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 308 Coliseum Dr Ste 200, Macon, GA 31217 Phone: 478-314-0784 Fax: 478-745-2623 | |
David E Kent, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 308 Coliseum Dr, Suite 200, Macon, GA 31217 Phone: 478-742-2180 Fax: 478-745-2623 | |
Billie Luke Jackson, M.D. Dermatology Medicare: May Accept Medicare Assignments Practice Location: 440 Charter Blvd, Suite 2201, Macon, GA 31210 Phone: 478-477-5575 Fax: 478-477-0707 | |
David J Cohen, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 308 Coliseum Dr, Suite 200, Macon, GA 31217 Phone: 478-742-2180 Fax: 478-745-2623 | |
Bruce Stuart Allen, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 1338 Old Forsyth Rd, Macon, GA 31210 Phone: 478-471-7788 |