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General NPI Number Information
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NPI Number | 1265486203
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Entity Type | Individual
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Provider Name | SUNDEEP - CHAUDHRY M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1117 PERIMETER CTR W W-211
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City | ATLANTA
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State | GA
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Zip | 30338-5451
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Country | US
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Telephone | 678-636-3062
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Fax | 678-636-3086
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Provider Business Mailing Address
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Address Line | 1670 RESERVE WAY
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City | DECATUR
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State | GA
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Zip | 30033-1541
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Country | US
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Telephone | 404-966-1670
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Fax | 404-320-9432
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 044188
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License Number State | GA
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