Provider Demographics
NPI:1841245719
Name:ARJUNAN, SURABHI (MD)
Entity Type:Individual
Prefix:
First Name:SURABHI
Middle Name:
Last Name:ARJUNAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4480 N COOPER LAKE RD SE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-4622
Mailing Address - Country:US
Mailing Address - Phone:770-333-2035
Mailing Address - Fax:770-333-2059
Practice Address - Street 1:4480 N COOPER LAKE RD SE
Practice Address - Street 2:SUITE 201
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-4622
Practice Address - Country:US
Practice Address - Phone:770-333-2035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-083318207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH98134Medicare UPIN
AR7317661Medicare ID - Type Unspecified