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MR. SANJAY MANOHAR ATHAVALE M.D.

>> Otolaryngology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1942404421

Individual Registrant:
MR. SANJAY MANOHAR ATHAVALE M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
100 DAWSON COMMONS CIRCLE SUITE 140 DAWSONVILLE, GA 30534 US
Tel: 770-217-6224  Fax: 706-216-4830

Contact information for business:
100 DAWSON COMMONS CIRCLE SUITE 140 DAWSONVILLE, GA 30534 US
Tel: 770-217-6224  Fax: 706-216-4830

Registration Information:
NPI: 1942404421
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Y00000XAllopathic & Osteopathic Physicians
Otolaryngology
GA69172

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
003131877IGA05
003131877JGA05
003131877MGA05




HEALTH CARE JOBS GA - Page 1



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