MEDICARE: DR. SAHAN D VANGALA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1740117803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAHAN D VANGALA

Provider Business Mailing Address
First Line	:	522 HARGROVE LN
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-2387
Country	:	US
Telephone Number	:	478-960-5828
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 JESSE HILL JR DR SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30303-3031
Country	:	US
Telephone Number	:	478-973-4390
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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Directions to “ DR. SAHAN D VANGALA ” Practice Location

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