Provider Demographics
NPI:1881715027
Name:VANDANA ANAND, M.D
Entity type:Organization
Organization Name:VANDANA ANAND, M.D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VANDANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-389-8100
Mailing Address - Street 1:155 EAGLES WALK
Mailing Address - Street 2:SUITE F
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-6342
Mailing Address - Country:US
Mailing Address - Phone:770-389-8100
Mailing Address - Fax:770-389-3030
Practice Address - Street 1:155 EAGLES WALK
Practice Address - Street 2:SUITE F
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-6342
Practice Address - Country:US
Practice Address - Phone:770-389-8100
Practice Address - Fax:770-389-3030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0358042084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA26BDGLJ02Medicare ID - Type Unspecified
GAF65104Medicare UPIN