Provider Demographics
NPI:1215255203
Name:KHICHI, SUNNY SINGH (MD)
Entity type:Individual
Prefix:
First Name:SUNNY
Middle Name:SINGH
Last Name:KHICHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2500 HOSPITAL BOULEVARD
Mailing Address - Street 2:SUITE 450
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-4919
Mailing Address - Country:US
Mailing Address - Phone:770-343-8675
Mailing Address - Fax:770-343-6297
Practice Address - Street 1:2500 HOSPITAL BOULEVARD
Practice Address - Street 2:SUITE 450
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4919
Practice Address - Country:US
Practice Address - Phone:770-343-8675
Practice Address - Fax:770-343-6297
Is Sole Proprietor?:No
Enumeration Date:2010-05-14
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA73705207Y00000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology