Periyasamy Thandavan, Sudharsan

Periyasamy Thandavan, Sudharsan is an individual health care provider with primary practice located at 2744 Washington Rd , Augusta GA 30909-2218. He recently has only one registered license in Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist, which is considered as his primary health care specialty. Periyasamy Thandavan, Sudharsan can be contacted via phone (706) 733-4277.

Contact Information

Primary practice address
2744 Washington Rd Augusta GA 30909-2218
Phone: (706) 733-4277
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X RPH028705 Georgia

Profile Details

NPI number 1457726663
LBN Legal business name Periyasamy Thandavan, Sudharsan
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2015
Last updated Dec 14th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457726663 NPPES
Georgia Other UIJ945A15732 BLUECROSS BLUESHEILD

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