Healthcare Provider Details

I. General information

NPI: 1376503128
Provider Name (Legal Business Name): SANDRA LYNN GREGORY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SANDRA LYNN WINER MD

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 PRESTON RIDGE RD STE 100
ALPHARETTA GA
30005-4509
US

IV. Provider business mailing address

3330 PRESTON RIDGE RD SUITE 300
ALPHARETTA GA
30005-4508
US

V. Phone/Fax

Practice location:
  • Phone: 770-255-7500
  • Fax: 770-255-7501
Mailing address:
  • Phone: 770-350-0126
  • Fax: 770-350-6637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number13630-320
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number057368
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: