Healthcare Provider Details

I. General information

NPI: 1073450318
Provider Name (Legal Business Name): FORSYTH SLEEP MD AND ESTHETICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3410 COMMANDER COVE SUITE B1
SUWANEE GA
30024
US

IV. Provider business mailing address

1035 WESCOTT AVE
SUWANEE GA
30024-5544
US

V. Phone/Fax

Practice location:
  • Phone: 708-539-6173
  • Fax:
Mailing address:
  • Phone: 708-539-6173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PADMAJA SANAPUREDDY
Title or Position: OWNER
Credential: MD
Phone: 708-539-6173