Provider Demographics
NPI:1659404044
Name:LAVANIA, SACHIN (MD)
Entity Type:Individual
Prefix:
First Name:SACHIN
Middle Name:
Last Name:LAVANIA
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:P.O. BOX 742342
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-2342
Mailing Address - Country:US
Mailing Address - Phone:770-410-4366
Mailing Address - Fax:770-410-4644
Practice Address - Street 1:2500 HOSPITAL BOULEVARD
Practice Address - Street 2:SUITE 420
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4919
Practice Address - Country:US
Practice Address - Phone:770-410-4366
Practice Address - Fax:770-410-4644
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA63915207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine