Healthcare Provider Details

I. General information

NPI: 1144203233
Provider Name (Legal Business Name): PRADEEP KUMAR SINHA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 02/12/2020
Certification Date: 02/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5670 PEACHTREE DUNWOODY RD NE SUITE 1280
ATLANTA GA
30342-1699
US

IV. Provider business mailing address

5670 PEACHTREE DUNWOODY RD NE SUITE 1280
ATLANTA GA
30342-1699
US

V. Phone/Fax

Practice location:
  • Phone: 404-257-1589
  • Fax: 404-303-1950
Mailing address:
  • Phone: 404-257-1589
  • Fax: 404-303-1950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number44104
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number044104
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: