SUDHARSAN PERIYASAMY THANDAVAN PHD NPI 1457726663

NPI Information

NPI: 1457726663
Provider Name: SUDHARSAN PERIYASAMY THANDAVAN, PHD
Classification: Pharmacist - 1835P0018X
Entity Type: Individual

Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Address:
2744 WASHINGTON RD
AUGUSTA, GA
ZIP 30909
Phone: (706) 733-4277
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Sudharsan Periyasamy Thandavan, PHD is a pharmacist clinician (phc)/ clinical pharmacy specialist pharmacist in Augusta, GA. The provider is pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. Sudharsan Periyasamy Thandavan, PHD NPI is 1457726663. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2744 WASHINGTON RD
AUGUSTA, GA
ZIP 30909-218
Phone: (706) 733-4277

The enumeration date for this NPI number is 12/14/2015 and was last updated on 12/14/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1835P0018X	Pharmacist	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	RPH028705	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	UIJ945A15732	OTHER	GEORGIA	BLUECROSS BLUESHEILD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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