Provider Demographics
NPI:1831311190
Name:INANKUR, AYSHA (MD)
Entity type:Individual
Prefix:DR
First Name:AYSHA
Middle Name:
Last Name:INANKUR
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:PO BOX 12938
Mailing Address - Street 2:C/O CLINIC MANAGEMENT
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30703
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 TIMMS RD NE
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701
Practice Address - Country:US
Practice Address - Phone:706-879-5820
Practice Address - Fax:706-879-5821
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012-01895207RE0101X
GA075007207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2969677Medicaid
NC17627OtherBCBS NC
GAGRP4720OtherGRP #
NCP01420250OtherRR MEDICARE
GA003175900AMedicaid
OH4267232Medicare PIN
OH4267231Medicare PIN