Individual
NIRAJ KHANDELWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MHS
Contact information
Practice address
1265 HIGHWAY 54 W, SUITE 402, FAYETTEVILLE, GA 30214-4548
(770) 719-3240
(770) 719-3241
Mailing address
95 COLLIER RD NW, SUITE 4075, ATLANTA, GA 30309-1796
(404) 355-3200
(404) 355-9316
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
57.017193
OH
207RG0100X
Gastroenterology Physician
Primary
67781
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP1-0022713
INSTITUTIONAL PERMIT
—
Enumeration date
05/21/2007
Last updated
07/09/2012
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