Provider Demographics
NPI:1619193844
Name:GANDIGA, PRATEEK CHANDRASHEKAR (MD)
Entity Type:Individual
Prefix:DR
First Name:PRATEEK
Middle Name:CHANDRASHEKAR
Last Name:GANDIGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1365 CLIFTON ROAD, NE
Mailing Address - Street 2:EMORY CLINIC, DEPT OF MEDICINE, BLDG. A- SUITE AT441
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1013
Mailing Address - Country:US
Mailing Address - Phone:404-778-0801
Mailing Address - Fax:
Practice Address - Street 1:1365 CLIFTON RD NE BLDG A
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-2113
Practice Address - Country:US
Practice Address - Phone:404-778-3539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD038949208M00000X
GA078547207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCP00894798OtherRAILROAD MEDICARE
DC193998YT2Medicare PIN