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Contact Information

SUPRAJA R GULLA, MD
4945 WILLIAMS DR
GEORGETOWN, TX78633-2008
 Phone: 317-962-2894
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Hospitalist

208M00000X
Indicates primary specialty

NPI Profile & details for SUPRAJA R GULLA · (Female)

NPI Number 1104076389
Status Active
Credentials MD
Entity Individual
Enumeration date 09/24/2008
Last updated 07/27/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 125.054210
  • IN License # 01069786A
  • TX License # T4929
  • IN Medicaid 201037090
Hospital affiliation(s)
  • NASH GENERAL HOSPITAL - (Acute Care)
    2460 CURTIS ELLIS DRIVE
    ROCKY MOUNT, NC 27804
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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