SUPRIYA IMMANENI, MD
Dermatology - MOHS-Micrographic Surgery
Active
Individual
NPI: 1497129399
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Dermatology | 207N00000X | No | 95284 (GA) |
| Dermatology - MOHS-Micrographic Surgery | 207ND0101X | Yes | 95284 (GA) |
Frequently Asked Questions
NPI 1497129399 is the National Provider Identifier for SUPRIYA IMMANENI, MD, a Dermatology - MOHS-Micrographic Surgery provider located in Macon, GA. This NPI was enumerated on November 17, 2015.
SUPRIYA IMMANENI, MD practices at 308 COLISEUM DR, ST 200, Macon, GA 31217.
Quick Facts
- NPI
- 1497129399
- Type
- Individual
- Enumerated
- Nov 17, 2015
- Last Updated
- Jan 13, 2026
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