Individual provider · Type 1 NPI
Supriya Immaneni, MD
MOHS-Micrographic Surgery Physician · Macon, GA
Practice location
308 Coliseum Dr, St 200
Macon, GA 31217-3865
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology Physician | 207N00000X | 95284 (GA) |
| MOHS-Micrographic Surgery Physician Primary | 207ND0101X | 95284 (GA) |
MOHS-Micrographic Surgery Physician: The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one…
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About NPI 1497129399
Supriya Immaneni, MD's National Provider Identifier is 1497129399, issued on Nov 17, 2015. The primary taxonomy on file is MOHS-Micrographic Surgery Physician (207ND0101X), and the practice location is in Macon, GA. The record was last updated on Jan 13, 2026.