Provider Demographics
NPI:1689633901
Name:SARIPKIN, LARRY MARVIN (MD)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:MARVIN
Last Name:SARIPKIN
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 1:993D JOHNSON FERRY ROAD
Mailing Address - Street 2:SUITE 440
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342
Mailing Address - Country:US
Mailing Address - Phone:404-257-0799
Mailing Address - Fax:404-503-2280
Practice Address - Street 1:993D JOHNSON FERRY ROAD
Practice Address - Street 2:SUITE 440
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342
Practice Address - Country:US
Practice Address - Phone:404-257-0799
Practice Address - Fax:404-503-2280
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0263762080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4060600OtherAETNA MC PPO PIN
GA000293895DMedicaid
2569966002OtherCIGNA
52025932008OtherBLUE CHOICE PROVIDER ID
1253888OtherUNITED HEALTH CARE
2134607OtherAETNA HMO POS
992OtherKAISER
593252OtherBLUE CHOICE FAC
52025932008OtherBLUE CHOICE PROVIDER ID