Provider Demographics
NPI:1922086610
Name:MUNJAL, DEEPTI A (MD)
Entity Type:Individual
Prefix:DR
First Name:DEEPTI
Middle Name:A
Last Name:MUNJAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1835 SAVOY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1072
Mailing Address - Country:US
Mailing Address - Phone:770-942-0457
Mailing Address - Fax:770-942-7699
Practice Address - Street 1:4586 TIMBER RIDGE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-7517
Practice Address - Country:US
Practice Address - Phone:770-942-0457
Practice Address - Fax:770-942-7699
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2020-08-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA046627207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000810301AFMedicaid
GA000810301AEMedicaid
GA202I832075Medicare PIN
GA000810301AEMedicaid