Individual
SANJAY STANLEY MASILAMANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
97 GREAT TEAYS BLVD STE 6, SCOTT DEPOT, WV 25560-9816
(304) 757-6999
(304) 201-5019
Mailing address
3495 PIEDMONT RD NE BLDG 91, ATTN TOBIE SHELLEY, ATLANTA, GA 30305-1717
(404) 364-7070
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
078825
GA
2084P0800X
Psychiatry Physician
390200000X
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0083183
—
OH
05
—
3810021770
—
WV
05
—
7100223220
—
KY
Enumeration date
05/29/2008
Last updated
01/06/2022
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