Credit Card Payments
for Ganesh Deshmukh MD, Adewunmi Adeyemo MD, Vishnu Pemmaraju MD
Please choose the name of the physician on your bill
*
Please Select
Ganesh Deshmukh MD
Adewunmi Adeywmo MD
Vishnu Pemmaraju MD
Payment Amount
*
prev
next
( X )
USD
Description
Credit Card
Name- please enter name on statement
*
First Name
Last Name
Please enter account number on your invoice
*
Please enter your email address
*
example@example.com
Please upload a picture of statement sent to you
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: