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Individual

PRAVEEN RASTOGI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, FCCP, ABSM

Contact information

Practice address
915 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5011
(770) 996-6699
(770) 997-4790
Mailing address
915 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5011
(770) 996-6699
(770) 997-4790

Taxonomy

Speciality
Code
Description
License number
State
173F00000X
Sleep Specialist (PhD)
Primary
26176
GA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
26176
GA
207RP1001X
Pulmonary Disease Physician
26176
GA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
26176
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002866668A
GA
Enumeration date
02/15/2006
Last updated
03/04/2022
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