Provider Demographics
NPI:1922065226
Name:FRYHOFER, SANDRA ADAMSON (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:ADAMSON
Last Name:FRYHOFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3290 NORTHSIDE PKWY NW STE 840
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-2211
Mailing Address - Country:US
Mailing Address - Phone:404-816-8660
Mailing Address - Fax:404-816-8657
Practice Address - Street 1:3290 NORTHSIDE PKWY NW STE 840
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-2211
Practice Address - Country:US
Practice Address - Phone:404-816-8660
Practice Address - Fax:404-816-8657
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA26430207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD39904Medicare UPIN