Organization
SANDY PLAINS MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN GLAESER (MANAGING PARTNER)
(678) 560-5278
Entity
Organization
Contact information
Practice address
3225 SHALLOWFORD RD STE 1300, MARIETTA, GA 30062-7033
(678) 560-7160
Mailing address
3225 SHALLOWFORD RD STE 1300, MARIETTA, GA 30062-7033
(678) 560-7160
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
02/12/2026
Last updated
02/12/2026
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