# REAGAN MEDICAL CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952316747
- **Authorized official:** MR. SATISH PODDAR MD (CEO)
- **Authorized official phone:** (678) 344-8700

## Contact information

- **Practice address:** 2696 LAWRENCEVILLE SUWANEE RD, SUWANEE, GA 30024-2535
- **Practice address phone:** (678) 344-8700
- **Mailing address:** 2878 FIVE FORKS TRICKUM RD, STE 2A, LAWRENCEVILLE, GA 30044-5896
- **Mailing address phone:** (678) 344-8700
- **Mailing address fax:** (678) 344-8600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207T00000X | Neurological Surgery Physician | — | NULL | — |
| 207T00000X | Neurological Surgery Physician | — | — | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |

## Other

- **Enumeration date:** 07/30/2006
- **Last updated:** 04/05/2024