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General NPI Number Information
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NPI Number | 1659583938
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Entity Type | Individual
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Provider Name | SATHISH KANNAN SHANMUGA SUNDARA PERUMAL MD
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Gender | Male
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 105 FISCHER MARKETPLACE LN STE 100
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City | SHARPSBURG
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State | GA
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Zip | 30277-3680
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Country | US
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Telephone | 678-633-3260
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Fax |
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Provider Business Mailing Address
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Address Line | 2727 PACES FERRY RD SE STE 1-1100
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City | ATLANTA
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State | GA
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Zip | 30339-6151
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Country | US
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Telephone | 470-271-3418
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 78489
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License Number State | GA
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