Provider Demographics
NPI:1073833083
Name:SANGAPU, SAHITHI S (MD)
Entity Type:Individual
Prefix:
First Name:SAHITHI
Middle Name:S
Last Name:SANGAPU
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:PO BOX 742616
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-2616
Mailing Address - Country:US
Mailing Address - Phone:770-219-8420
Mailing Address - Fax:
Practice Address - Street 1:3931 MUNDY MILL RD
Practice Address - Street 2:SUITE A
Practice Address - City:OAKWOOD
Practice Address - State:GA
Practice Address - Zip Code:30566-3431
Practice Address - Country:US
Practice Address - Phone:770-848-9100
Practice Address - Fax:770-848-9101
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA64260207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine