Provider Demographics
NPI:1235140286
Name:BANKS, SANDRA K (MD)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:K
Last Name:BANKS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5670 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1699
Mailing Address - Country:US
Mailing Address - Phone:404-255-9100
Mailing Address - Fax:404-257-7171
Practice Address - Street 1:5670 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:SUITE 1200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1699
Practice Address - Country:US
Practice Address - Phone:404-255-9100
Practice Address - Fax:404-257-7171
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2017-01-30
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Provider Licenses
StateLicense IDTaxonomies
GA048330207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003129261AMedicaid
GA003129261AMedicaid