Provider Demographics
NPI:1013417526
Name:SURA, HEMA (DC)
Entity Type:Individual
Prefix:DR
First Name:HEMA
Middle Name:
Last Name:SURA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 TERRELL MILL RD SE APT 24J
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-6078
Mailing Address - Country:US
Mailing Address - Phone:901-319-3115
Mailing Address - Fax:
Practice Address - Street 1:1550 TERRELL MILL RD SE APT 24J
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-6078
Practice Address - Country:US
Practice Address - Phone:901-319-3115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO10000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor