Provider Demographics
NPI:1194861971
Name:SANDVI, MUHAMMAD ASLAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:ASLAM
Last Name:SANDVI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 ROSS DR
Mailing Address - Street 2:SUITE1
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-3095
Mailing Address - Country:US
Mailing Address - Phone:706-278-2962
Mailing Address - Fax:706-226-0746
Practice Address - Street 1:1421 ROSS DR
Practice Address - Street 2:SUITE1
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-3095
Practice Address - Country:US
Practice Address - Phone:706-278-2962
Practice Address - Fax:706-226-0746
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0140212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00134483DMedicaid
GAD41045Medicare UPIN
GA26LCBCFMedicare ID - Type Unspecified