Individual
POOJA MAYUR SAMPAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4222 FAIRBANKS DR, OAKWOOD, GA 30566-2811
(770) 534-6053
(770) 534-6695
Mailing address
PO BOX 1060, OAKWOOD, GA 30566-0018
(770) 534-6053
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
101460
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003254669B
—
GA
05
—
003311709A
—
GA
05
—
003311709B
—
GA
Enumeration date
04/01/2021
Last updated
02/03/2026
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