Provider Demographics
NPI:1598474207
Name:STRATEGIC GEORGIA PHYSICIANS GROUP PC
Entity Type:Organization
Organization Name:STRATEGIC GEORGIA PHYSICIANS GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARVIND
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAKRAVARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-814-0963
Mailing Address - Street 1:2068 WHEATON WAY
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4954
Mailing Address - Country:US
Mailing Address - Phone:810-814-0963
Mailing Address - Fax:
Practice Address - Street 1:2068 WHEATON WAY
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4954
Practice Address - Country:US
Practice Address - Phone:810-814-0963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SC2300XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistChronic CareGroup - Single Specialty