Provider Demographics
NPI:1154424604
Name:HOODA, SUDERSHAN KUMAR (MD)
Entity type:Individual
Prefix:MR
First Name:SUDERSHAN
Middle Name:KUMAR
Last Name:HOODA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:511 N COBB ST
Mailing Address - Street 2:SUITE 13
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061
Mailing Address - Country:US
Mailing Address - Phone:478-453-9472
Mailing Address - Fax:478-453-3134
Practice Address - Street 1:511 N COBB ST
Practice Address - Street 2:SUITE 13
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061
Practice Address - Country:US
Practice Address - Phone:478-453-9472
Practice Address - Fax:478-453-3134
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2008-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA021521207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000209822BMedicaid
GA000209822BMedicaid