Basic Information
| Provider Information | |||||||||
| NPI: | 1659781482 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SUTHAR | ||||||||
| FirstName: | SNEHA | ||||||||
| MiddleName: | |||||||||
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| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3655 HOWELL FERRY RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | DULUTH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300963186 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7704978283 | ||||||||
| FaxNumber: | 4044814433 | ||||||||
| Practice Location | |||||||||
| Address1: | 3655 HOWELL FERRY RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | DULUTH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300963186 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7704978283 | ||||||||
| FaxNumber: | 4044814433 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2014 | ||||||||
| LastUpdateDate: | 04/02/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | POD001322 | GA | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
No ID Information.