Provider Demographics
NPI:1851041347
Name:MODI, SANIL SAUMEEL (MD)
Entity Type:Individual
Prefix:
First Name:SANIL
Middle Name:SAUMEEL
Last Name:MODI
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 1:833 CAMPBELL HILL ST NW STE 250
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1162
Mailing Address - Country:US
Mailing Address - Phone:470-956-2020
Mailing Address - Fax:770-999-2785
Practice Address - Street 1:833 CAMPBELL HILL ST NW STE 250
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1162
Practice Address - Country:US
Practice Address - Phone:470-956-2020
Practice Address - Fax:770-999-2785
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-27
Last Update Date:2022-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program