Provider Demographics
NPI:1043222128
Name:PANDEY, SIMA SURESH (MD)
Entity Type:Individual
Prefix:
First Name:SIMA
Middle Name:SURESH
Last Name:PANDEY
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 1:4895 WINDWARD PKWY STE 202
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-3850
Mailing Address - Country:US
Mailing Address - Phone:770-475-0888
Mailing Address - Fax:
Practice Address - Street 1:725 N BROAD ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-2347
Practice Address - Country:US
Practice Address - Phone:908-351-8989
Practice Address - Fax:908-351-8879
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA079850207R00000X
GA055871207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine