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Individual

MR. SANJAY MANOHAR ATHAVALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 DAWSON COMMONS CIRCLE, SUITE 140, DAWSONVILLE, GA 30534
(770) 217-6224
(706) 216-4830
Mailing address
100 DAWSON COMMONS CIRCLE, SUITE 140, DAWSONVILLE, GA 30534
(770) 217-6224
(706) 216-4830

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
69172
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003131877I
GA
05
003131877J
GA
05
003131877M
GA
Enumeration date
06/11/2007
Last updated
06/17/2019
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