Individual
BHAGYA SANNANANJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
(404) 712-2080
Mailing address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
86080
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417326752
—
WA
Enumeration date
09/16/2015
Last updated
10/08/2020
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