Provider Demographics
NPI:1902883168
Name:SUBRAMANIAN, SENDHIL K (MD)
Entity type:Individual
Prefix:DR
First Name:SENDHIL
Middle Name:K
Last Name:SUBRAMANIAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1830 COLLAND DR NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-2604
Mailing Address - Country:US
Mailing Address - Phone:678-468-0419
Mailing Address - Fax:
Practice Address - Street 1:5505 PEACHTREE DUNWOODY RD STE 370
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1713
Practice Address - Country:US
Practice Address - Phone:678-447-0616
Practice Address - Fax:833-450-0491
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0491072085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0009073871Medicaid
GA000907387Medicaid
GA30BDLRCMedicaid
GA30BDNLJMedicare PIN
GA0009073871Medicaid