MEDICARE: DR. SONALI GANGULY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	92297	GA

General Provider Information

NPI Number	:	1215666862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SONALI GANGULY MD

Provider Business Mailing Address
First Line	:	PO BOX 1060
Second Line	:
City	:	OAKWOOD
State	:	GA
Zip	:	30566-0018
Country	:	US
Telephone Number	:	770-297-2238
Fax Number	:

Provider Business Practice Location Address
First Line	:	1120 PEACHTREE INDUSTRIAL BLVD
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-2322
Country	:	US
Telephone Number	:	770-207-4620
Fax Number	:	678-207-4619

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2022
Last Update Date	:	02/04/2026

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