Provider Demographics
NPI:1487830493
Name:KIM, SAJEEVANI GUNASINGHE (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:SAJEEVANI
Middle Name:GUNASINGHE
Last Name:KIM
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 NORTHSIDE CHEROKEE BLVD STE 480
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-8034
Mailing Address - Country:US
Mailing Address - Phone:404-962-6000
Mailing Address - Fax:
Practice Address - Street 1:470 NORTHSIDE CHEROKEE BLVD STE 480
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-8034
Practice Address - Country:US
Practice Address - Phone:404-962-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-21
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA98138207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease