Provider Demographics
NPI:1003092347
Name:DEVANATH, ANINDITA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANINDITA
Middle Name:
Last Name:DEVANATH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2916 CLAIRMONT RD NE
Mailing Address - Street 2:APT 1407
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-4441
Mailing Address - Country:US
Mailing Address - Phone:404-308-3428
Mailing Address - Fax:
Practice Address - Street 1:1364 CLIFTON RD NE # H185A
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1059
Practice Address - Country:US
Practice Address - Phone:404-712-8210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002645207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology