Healthcare Provider Details

I. General information

NPI: 1801049705
Provider Name (Legal Business Name): SANA MUNEER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2008
Last Update Date: 07/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1873 EAST MAIN STREET STE. B
HOGANSVILLE GA
30230-2756
US

IV. Provider business mailing address

1873 EAST MAIN STREET STE. B
HOGANSVILLE GA
30230-2756
US

V. Phone/Fax

Practice location:
  • Phone: 706-637-9797
  • Fax: 706-812-2862
Mailing address:
  • Phone: 706-637-9797
  • Fax: 706-812-2862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number003049
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number66539
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: