Provider Demographics
NPI:1306932983
Name:GOGINENI, SAMRAJYA LK (MD)
Entity type:Individual
Prefix:DR
First Name:SAMRAJYA
Middle Name:LK
Last Name:GOGINENI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 84009
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31908-4009
Mailing Address - Country:US
Mailing Address - Phone:229-312-5800
Mailing Address - Fax:229-312-5853
Practice Address - Street 1:1390 US HIGHWAY 19 S
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:GA
Practice Address - Zip Code:31763-4831
Practice Address - Country:US
Practice Address - Phone:229-312-7490
Practice Address - Fax:229-312-7495
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2011-11-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA025160207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine