Provider Demographics
NPI:1699770065
Name:SOHANI, SADIQ (MD)
Entity type:Individual
Prefix:DR
First Name:SADIQ
Middle Name:
Last Name:SOHANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1413 CHATTANOOGA AVENUE
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-2631
Mailing Address - Country:US
Mailing Address - Phone:706-279-2635
Mailing Address - Fax:706-279-2679
Practice Address - Street 1:1413 CHATTANOOGA AVENUE
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-2631
Practice Address - Country:US
Practice Address - Phone:706-279-2635
Practice Address - Fax:706-279-2679
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2019-10-09
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-31
Provider Licenses
StateLicense IDTaxonomies
GA45010207LP2900X
GA045010208VP0014X
TNMD0000029961208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00139202OtherRAILROAD MCARE INDIVIDUAL
TN4078481OtherBCBS TN
GA000885882CMedicaid
GA976829OtherBCBS GA
TN4078481OtherBCBS TN
GA000885882CMedicaid