Provider Demographics
NPI:1912943952
Name:SANKARAN, SEKHAR C (MD)
Entity type:Individual
Prefix:
First Name:SEKHAR
Middle Name:C
Last Name:SANKARAN
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 1:101 REGENCY PARK DR
Mailing Address - Street 2:STE 140
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253
Mailing Address - Country:US
Mailing Address - Phone:770-957-8626
Mailing Address - Fax:770-957-7200
Practice Address - Street 1:101 REGENCY PARK DR
Practice Address - Street 2:STE 140
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253
Practice Address - Country:US
Practice Address - Phone:770-957-8626
Practice Address - Fax:770-957-7200
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA031549208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
E71171Medicare UPIN