Basic Information
| Provider Information | |||||||||
| NPI: | 1578829412 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SAMSARA WORKS CORPORATION | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | SOMANU MEDICAL WEIGHT LOSS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5013 | ||||||||
| Address2: | |||||||||
| City: | MONTGOMERY | ||||||||
| State: | AL | ||||||||
| PostalCode: | 361035013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3343860378 | ||||||||
| FaxNumber: | 3343860382 | ||||||||
| Practice Location | |||||||||
| Address1: | 12990 HIGHWAY 9 N | ||||||||
| Address2: | SUITE 114 | ||||||||
| City: | MILTON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300044195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6782420204 | ||||||||
| FaxNumber: | 6782420406 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2012 | ||||||||
| LastUpdateDate: | 04/04/2012 | ||||||||
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| AuthorizedOfficialLastName: | DONIPARTHI | ||||||||
| AuthorizedOfficialFirstName: | NALINIKRISHNA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3343860378 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.