Healthcare Provider Details

I. General information

NPI: 1881790822
Provider Name (Legal Business Name): RAJNEESH SEHGAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 01/21/2022
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ACADEMY ST NW
GAINESVILLE GA
30501-8568
US

IV. Provider business mailing address

5118 STRATMOR CT
STONE MOUNTAIN GA
30087-1148
US

V. Phone/Fax

Practice location:
  • Phone: 770-282-8820
  • Fax:
Mailing address:
  • Phone: 678-362-5202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number052094
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: