Individual
DR. SANDEEP JAGLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 WHITCHER ST NE, SUITE 460, MARIETTA, GA 30060-1155
(770) 427-7389
(770) 427-2845
Mailing address
55 WHITCHER ST NE, SUITE 460, MARIETTA, GA 30060-1155
(770) 427-7389
(770) 427-2845
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
057561
GA
207RN0300X
Nephrology Physician
Primary
GA057561
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057561
STATE LICENSE
GA
05
—
955029596A
—
GA
05
—
955029596AA
—
GA
05
—
955029596B
—
GA
05
—
955029596C
—
GA
05
—
955029596F
—
GA
05
—
955029596I
—
GA
05
—
955029596L
—
GA
05
—
955029596M
—
GA
05
—
955029596N
—
GA
05
—
955029596O
—
GA
05
—
955029596P
—
GA
05
—
955029596Q
—
GA
05
—
955029596R
—
GA
05
—
955029596S
—
GA
05
—
955029596T
—
GA
05
—
955029596U
—
GA
05
—
955029596V
—
GA
05
—
955029596W
—
GA
05
—
955029596X
—
GA
05
—
955029596Y
—
GA
Enumeration date
06/20/2006
Last updated
08/01/2019
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