Provider Demographics
NPI:1902196629
Name:ARUMUGASAAMY, ANUSHKA VAVITRA (MD)
Entity Type:Individual
Prefix:
First Name:ANUSHKA
Middle Name:VAVITRA
Last Name:ARUMUGASAAMY
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 1:4441 ATLANTA RD SE STE 312
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6443
Mailing Address - Country:US
Mailing Address - Phone:470-956-4200
Mailing Address - Fax:
Practice Address - Street 1:4441 ATLANTA RD SE STE 312
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6443
Practice Address - Country:US
Practice Address - Phone:470-956-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA79654208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery