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General NPI Number Information
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NPI Number | 1356764211
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Entity Type | Organization
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Legal Business Name | DA VINCI MEDICAL ARTS
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Dates
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Enumeration Date | 01/29/2014
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Last Update Date | 01/29/2014
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Provider Practice Location Address
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Address Line | 2911 GEORGE BUSBEE PKWY NW
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City | KENNESAW
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State | GA
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Zip | 30144-6908
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Country | US
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Telephone | 404-759-0590
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Fax |
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Provider Business Mailing Address
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Address Line | 1998 NORTHSIDE DR NW
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City | ATLANTA
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State | GA
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Zip | 30318-2672
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Country | US
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Telephone | 404-759-0590
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SONNY DOSANJH
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Credential | MD
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Telephone | 404-759-0590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 66686
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License Number State | GA
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