Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 75887 | GA |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 75887 | GA |
NPI | 1053701268 |
---|---|
Provider Name | Dr. Vivek Saroha |
First Address | Decatur, GA 30030-3773 |
Second Address | Atlanta, GA 30322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2015 |
Last Update Date | 07/08/2019 |