Healthcare Provider Details

I. General information

NPI: 1174784748
Provider Name (Legal Business Name): ANURAG SAHU M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 08/06/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 GLENLAKE PARKWAY NE MEDICAL OFFICE BUILDING
SANDY SPRINGS GA
30328
US

IV. Provider business mailing address

PO BOX 37174
BALTIMORE MD
21297-3174
US

V. Phone/Fax

Practice location:
  • Phone: 404-365-0966
  • Fax:
Mailing address:
  • Phone: 571-423-5699
  • Fax: 571-423-5698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0002X
TaxonomyAdult Congenital Heart Disease Physician
License Number065174
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD-14819
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number065174
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101274897
License Number StateVA
# 5
Primary TaxonomyY
Taxonomy Code207RA0002X
TaxonomyAdult Congenital Heart Disease Physician
License Number0101274897
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: