Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Supriya Immaneni, MD

Individual provider Dermatology Physician · NPI 1497129399

Supriya Immaneni, MD is a Micrographic Dermatologic Surgery (Mds) in Macon, Georgia. Graduated from Northwestern University Feinberg Medical School in 2019, 7 years ago. Practices with Georgia Dermatology Specialists PC, a 16-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
7
Trained at
Northwestern University Feinberg Medical School
Licensed in
GA
In the registry since
2015
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

308 Coliseum Dr St 200
Macon, GA 31217-3865
Phone: (478) 742-2180
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

MOHS-Micrographic Surgery Physician (primary) Taxonomy 207ND0101X · Licence 95284 (GA)
Dermatology Physician Taxonomy 207N00000X · Licence 95284 (GA)

Record details

NPI number1497129399
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 17, 2015
Last updated in NPPESJanuary 13, 2026
Certification dateJanuary 13, 2026
Mailing address308 Coliseum Dr, St 200, Macon, GA 31217-3865

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMICROGRAPHIC DERMATOLOGIC SURGERY (MDS)
Also practisesDERMATOLOGY
Medical schoolNORTHWESTERN UNIVERSITY FEINBERG MEDICAL SCHOOL
Graduated 2019 (7 years in practice)
Group practice Georgia Dermatology Specialists Pc — 16 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Macon