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General NPI Number Information
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NPI Number | 1356664007
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Entity Type | Individual
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Provider Name | PANCHAJANYA PAUL MD
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Gender | Male
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 6667 VERNON WOODS DR STE B20
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City | ATLANTA
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State | GA
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Zip | 30328-3216
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Country | US
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Telephone | 678-250-8883
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Fax | 678-916-6619
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Provider Business Mailing Address
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Address Line | 3070 WINDWARD PLZ # F345
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City | ALPHARETTA
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State | GA
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Zip | 30005-8771
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Country | US
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Telephone | 678-250-8883
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Fax | 678-916-6619
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 069419
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License Number State | GA
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