Provider Demographics
NPI:1366462160
Name:SAPPATI BIYYANI, RAJA SHEKHAR REDDY (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJA SHEKHAR
Middle Name:REDDY
Last Name:SAPPATI BIYYANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:711 CANTON RD NE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-8948
Mailing Address - Country:US
Mailing Address - Phone:678-741-2317
Mailing Address - Fax:404-944-4522
Practice Address - Street 1:711 CANTON RD NE
Practice Address - Street 2:SUITE 300
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-8948
Practice Address - Country:US
Practice Address - Phone:678-741-5000
Practice Address - Fax:678-819-4280
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA69437207RG0100X
OH35.087811207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003133852DMedicaid
GA202I106882Medicare PIN