Healthcare Provider Details

I. General information

NPI: 1588058879
Provider Name (Legal Business Name): VIDHYA SABAPATHY M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2015
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3890 JOHNS CREEK PKWY STE 180
SUWANEE GA
30024-0158
US

IV. Provider business mailing address

11660 ALPHARETTA HWY STE 430
ROSWELL GA
30076-3880
US

V. Phone/Fax

Practice location:
  • Phone: 678-551-6970
  • Fax:
Mailing address:
  • Phone: 770-255-1069
  • Fax: 770-255-1075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number85583
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: