Provider Demographics
NPI:1902819667
Name:KANAGARAJAN, NANDHAKUMAR (MD)
Entity Type:Individual
Prefix:
First Name:NANDHAKUMAR
Middle Name:
Last Name:KANAGARAJAN
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 1:550 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2208
Mailing Address - Country:US
Mailing Address - Phone:404-888-7575
Mailing Address - Fax:404-253-6896
Practice Address - Street 1:210 OAKSIDE LN
Practice Address - Street 2:SUITE C
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-6417
Practice Address - Country:US
Practice Address - Phone:678-593-1295
Practice Address - Fax:678-593-1294
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429444207R00000X
GA68180207RG0100X
MA247627207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine