Healthcare Provider Details

I. General information

NPI: 1386674679
Provider Name (Legal Business Name): LOTIKA PANDIT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 02/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6073 E BRAINERD RD
CHATTANOOGA TN
37421-3909
US

IV. Provider business mailing address

111 N PINE ST
TRENTON GA
30752-2503
US

V. Phone/Fax

Practice location:
  • Phone: 423-648-8008
  • Fax: 706-657-4400
Mailing address:
  • Phone: 706-657-3360
  • Fax: 706-657-4400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number28815
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number170313
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: