MEDICARE: AEGIS ENDOSCOPY LLC

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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1548129109
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AEGIS ENDOSCOPY LLC

Provider Business Mailing Address
First Line	:	3390 PADDOCKS PKWY STE 101
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-9119
Country	:	US
Telephone Number	:	770-400-0828
Fax Number	:	866-554-1774

Provider Business Practice Location Address
First Line	:	935 BUFORD RD STE 101
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30041-3222
Country	:	US
Telephone Number	:	678-528-0566
Fax Number	:	678-439-0865

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SUMANA MOOLE
Credential	:	MD
Telephone Number	:	770-400-0828

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	02/06/2026

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Directions to “AEGIS ENDOSCOPY LLC ” Practice Location

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