Provider Demographics
NPI:1215666862
Name:GANGULY, SONALI (MD)
Entity type:Individual
Prefix:DR
First Name:SONALI
Middle Name:
Last Name:GANGULY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SONALI
Other - Middle Name:
Other - Last Name:LAHIRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30503-0658
Mailing Address - Country:US
Mailing Address - Phone:770-297-2238
Mailing Address - Fax:
Practice Address - Street 1:1120 PEACHTREE INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-2322
Practice Address - Country:US
Practice Address - Phone:770-207-4620
Practice Address - Fax:678-207-4619
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA92297207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism