| Sanjeev S Tendolkar Md Llc | |
|
4589 Lawrenceville Rd Loganville GA 30052-7320 | |
| (770) 466-8672 | |
| Not Available |
| Full Name | Sanjeev S Tendolkar Md Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 4589 Lawrenceville Rd, Loganville, Georgia |
| Authorized Official Name and Position | Sanjeev Tendolkar (PRESIDENT) |
| Authorized Official Contact | 7705983397 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sanjeev S Tendolkar Md Llc 4589 Lawrenceville Rd Loganville GA 30052-7320 Ph: () - | Sanjeev S Tendolkar Md Llc 4589 Lawrenceville Rd Loganville GA 30052-7320 Ph: (770) 466-8672 |
| NPI Number | 1174878227 |
|---|---|
| Provider Enumeration Date | 07/16/2012 |
| Last Update Date | 07/16/2012 |
| Medicare PECOS PAC ID | 8527215029 |
|---|---|
| Medicare Enrollment ID | O20120905000296 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174878227 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 63066 (Georgia) | Primary |
| Provider Name | Sanjeev S Tendolkar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326258583 PECOS PAC ID: 9638215379 Enrollment ID: I20091009000086 |
| Provider Name | Bhavani Merugu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295212439 PECOS PAC ID: 3678824364 Enrollment ID: I20220128001570 |
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