Provider Demographics
NPI:1396971925
Name:SHIVDAT-NANHOE, ROSITA SADHANA (MD)
Entity type:Individual
Prefix:DR
First Name:ROSITA
Middle Name:SADHANA
Last Name:SHIVDAT-NANHOE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ROSITA
Other - Middle Name:SADHANA
Other - Last Name:NANHOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:116 HOSPITAL DR
Mailing Address - Street 2:STE A
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-4204
Mailing Address - Country:US
Mailing Address - Phone:478-733-6803
Mailing Address - Fax:478-225-2477
Practice Address - Street 1:116A HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-4204
Practice Address - Country:US
Practice Address - Phone:478-225-2297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA620812084N0600X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology