Individual
DR. SANJAY A. BHANSALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5881 GLENRIDGE DR NE, STE 230, ATLANTA, GA 30328-5301
(404) 943-0170
(404) 943-0171
Mailing address
5881 GLENRIDGE DR NE, STE 230, ATLANTA, GA 30328-5301
(404) 943-0170
(404) 943-0171
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
035006
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00476583D
—
GA
Enumeration date
06/01/2005
Last updated
10/24/2012
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