Basic Information
| Provider Information | |||||||||
| NPI: | 1912134644 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAHAJAN | ||||||||
| FirstName: | ANUJ | ||||||||
| MiddleName: | DINESH | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6300 HOSPITAL PKWY | ||||||||
| Address2: | SUITE 375 | ||||||||
| City: | JOHNS CREEK | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300971828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7707715260 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6300 HOSPITAL PKWY | ||||||||
| Address2: | SUITE 375 | ||||||||
| City: | JOHNS CREEK | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300971828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7707715260 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2009 | ||||||||
| LastUpdateDate: | 06/13/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | 75568 | GA | Y | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
No ID Information.