Healthcare Provider Details

I. General information

NPI: 1063025690
Provider Name (Legal Business Name): SAS MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2020
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8601 DUNWOODY PL STE 565
SANDY SPRINGS GA
30350-2519
US

IV. Provider business mailing address

8601 DUNWOODY PL STE 565
SANDY SPRINGS GA
30350-2516
US

V. Phone/Fax

Practice location:
  • Phone: 404-545-6969
  • Fax:
Mailing address:
  • Phone: 404-545-6969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: SHAYNA A ROAF
Title or Position: ORGANIZER
Credential: MD
Phone: 404-545-6969