Healthcare Provider Details

I. General information

NPI: 1447284138
Provider Name (Legal Business Name): RANJAN PAUL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 12/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4355 JOHN'S CREEK PARKWAY SUITE 500
SUWANEE GA
30024-6085
US

IV. Provider business mailing address

3245 PEACHTREE PARKWAY SUITE D-170
SUWANEE GA
30024-6008
US

V. Phone/Fax

Practice location:
  • Phone: 770-623-0008
  • Fax: 770-623-0009
Mailing address:
  • Phone: 770-623-0008
  • Fax: 770-623-0009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number054087
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number054087
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: