Healthcare Provider Details

I. General information

NPI: 1952712788
Provider Name (Legal Business Name): VAMSI KANAGALA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8735 DUNWOODY PL # 8456
SANDY SPRINGS GA
30350-2995
US

IV. Provider business mailing address

700 PARK REGENCY PL NE APT 901
ATLANTA GA
30326-4208
US

V. Phone/Fax

Practice location:
  • Phone: 404-458-7784
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number82102
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number29118
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: