Provider Demographics
NPI:1336330414
Name:SANFORD, NADIA SHEREE (MD)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:SHEREE
Last Name:SANFORD
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 1:8855 HOSPITAL DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-2267
Mailing Address - Country:US
Mailing Address - Phone:678-784-5020
Mailing Address - Fax:678-784-5024
Practice Address - Street 1:8855 HOSPITAL DR
Practice Address - Street 2:SUITE 101
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-2267
Practice Address - Country:US
Practice Address - Phone:678-784-5020
Practice Address - Fax:678-784-5024
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA062279207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology