Individual
DR. REZA H SUTANDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1404 RIVER PL STE 303, BRASELTON, GA 30517-5600
(770) 848-9335
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
35077882
OH
207V00000X
Obstetrics & Gynecology Physician
Primary
66908
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2193666
—
OH
Enumeration date
03/03/2006
Last updated
02/02/2023
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