Provider Demographics
NPI:1649254848
Name:PANDYA, UTPAL H (MD)
Entity type:Individual
Prefix:DR
First Name:UTPAL
Middle Name:H
Last Name:PANDYA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3495 PIEDMONT RD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1717
Mailing Address - Country:US
Mailing Address - Phone:404-364-7070
Mailing Address - Fax:419-383-2000
Practice Address - Street 1:20 GLENLAKE PKWY
Practice Address - Street 2:KAISER PERMANENTE GLENLAKE MEDICAL CENTER
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3473
Practice Address - Country:US
Practice Address - Phone:419-383-3925
Practice Address - Fax:419-383-6167
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2022-01-07
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Provider Licenses
StateLicense IDTaxonomies
GA064696207RC0000X
OH35086955207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPA4170751Medicare ID - Type Unspecified
H04344Medicare UPIN