Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 057169 | GA |
Y | 207VX0000X | Obstetrician | 057169 | GA |
NPI | 1033314422 |
---|---|
Provider Name | Dr. Peahen H Gandhi |
First Address | Canton, GA 30114-5256 |
Second Address | Canton, GA 30114-5256 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2007 |
Last Update Date | 30/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
057169 | GEORGIA STATE LICENSES (01) | GA |
1033314422 | (02) | |
16BBDLX | MEDICARE (01) | GA |
616316896A | (05) | GA |
616316896C | (05) | GA |
616316896D | (05) | GA |
616316896E | (05) | GA |