Provider Demographics
NPI:1487671319
Name:NANDI, SUDESHNA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUDESHNA
Middle Name:
Last Name:NANDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUDESHNA
Other - Middle Name:
Other - Last Name:MAZUMDAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:204 N DECATUR LN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-5947
Mailing Address - Country:US
Mailing Address - Phone:404-299-8724
Mailing Address - Fax:678-248-6208
Practice Address - Street 1:10160 MEDLOCK BRIDGE RD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-4419
Practice Address - Country:US
Practice Address - Phone:770-495-0011
Practice Address - Fax:770-495-0012
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA057135207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine