Provider Demographics
NPI:1225666175
Name:PERAMSETTY, SASANK RAHEEL (MD)
Entity Type:Individual
Prefix:
First Name:SASANK
Middle Name:RAHEEL
Last Name:PERAMSETTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1718 VETERANS MEMORIAL PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-4792
Mailing Address - Country:US
Mailing Address - Phone:205-507-1100
Mailing Address - Fax:205-553-3318
Practice Address - Street 1:1718 VETERANS MEMORIAL PKWY STE A
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-4792
Practice Address - Country:US
Practice Address - Phone:205-507-1100
Practice Address - Fax:205-553-3318
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.45792207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine