Datta, Sandeep

Datta, Sandeep is an individual health care provider with primary practice located at 101 Preston Ct Suite 103, Macon GA 31210-5772. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Datta, Sandeep can be contacted via phone (478) 745-2385.

Contact Information

Primary practice address
101 Preston Ct Suite 103 Macon GA 31210-5772
Phone: (478) 745-2385
Fax: (478) 745-1225
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 050473 Georgia
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 050473 Georgia
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X 050473 Georgia
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 050473 Georgia

Profile Details

NPI number 1477546166
LBN Legal business name Datta, Sandeep
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 26th, 2005
Last updated Feb 16th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477546166 NPPES
Georgia Other 580628385 TRICARE
Georgia Other P00160070 TRICARE
Georgia MEDICAID 000937637F TRICARE
Georgia MEDICAID 000937637I TRICARE
Georgia Other 670890 TRICARE
Georgia Other P01049978 TRICARE
Georgia MEDICAID 000937637D TRICARE
Georgia MEDICAID 000937637H TRICARE
Georgia Other 913282 TRICARE
Georgia MEDICAID 000937637C TRICARE
Georgia Other 01652025 TRICARE
Georgia MEDICAID 000937637B TRICARE
Georgia MEDICAID 000937637E TRICARE

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