Basic Information
Provider Information
NPI: 1528196284
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAHAI
FirstName: AMANDA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5080 SPECTRUM DRIVE
Address2: SUITE 1200 WEST TOWER
City: ADDISON
State: TX
PostalCode: 75001
CountryCode: US
TelephoneNumber: 8002323550
FaxNumber:  
Practice Location
Address1: 6475 JIMMY CARTER BLVD
Address2:  
City: NORCROSS
State: GA
PostalCode: 300711726
CountryCode: US
TelephoneNumber: 7702427744
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/02/2007
LastUpdateDate: 12/27/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X053719GAY Allopathic & Osteopathic PhysiciansFamily Medicine 
2083X0100X053719GAN Allopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine

No ID Information.


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