Provider Demographics
NPI:1114958675
Name:SETIA, VANDANA N (MD)
Entity Type:Individual
Prefix:DR
First Name:VANDANA
Middle Name:N
Last Name:SETIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1181 LANGFORD DR
Mailing Address - Street 2:BLDG 100 STE 101
Mailing Address - City:BOGART
Mailing Address - State:GA
Mailing Address - Zip Code:30622-2542
Mailing Address - Country:US
Mailing Address - Phone:706-546-9838
Mailing Address - Fax:706-546-9347
Practice Address - Street 1:1181 LANGFORD DR
Practice Address - Street 2:BLDG 100 STE 101
Practice Address - City:BOGART
Practice Address - State:GA
Practice Address - Zip Code:30622-2542
Practice Address - Country:US
Practice Address - Phone:706-546-9838
Practice Address - Fax:706-546-9347
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2013-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA042721207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000749647BMedicaid
GA000749647BMedicaid
GA08BDNCRMedicare ID - Type Unspecified