Provider Demographics
NPI:1215546999
Name:GANDRAPU BALANAGA, SATYA SAILAJA BINDU (MD)
Entity Type:Individual
Prefix:DR
First Name:SATYA SAILAJA BINDU
Middle Name:
Last Name:GANDRAPU BALANAGA
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 1:310 W 10TH ST NE
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-2639
Mailing Address - Country:US
Mailing Address - Phone:512-434-9064
Mailing Address - Fax:
Practice Address - Street 1:310 W 10TH ST NE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-2639
Practice Address - Country:US
Practice Address - Phone:413-447-2839
Practice Address - Fax:413-447-2088
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA90971208D00000X
MA281011390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice