MEDICARE: GEETANJALI VASANDANI MD

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	207R00000X	Internal Medicine Physician	43297	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740280791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEETANJALI VASANDANI MD

Provider Business Mailing Address
First Line	:	4424 HUGH HOWELL RD STE D
Second Line	:
City	:	TUCKER
State	:	GA
Zip	:	30084-4905
Country	:	US
Telephone Number	:	404-756-1400
Fax Number	:

Provider Business Practice Location Address
First Line	:	4424 HUGH HOWELL RD STE D
Second Line	:
City	:	TUCKER
State	:	GA
Zip	:	30084-4905
Country	:	US
Telephone Number	:	404-692-4466
Fax Number	:

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	03/14/2023

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