Pendem, Shanthan

Pendem, Shanthan is an individual health care provider with primary practice located at 1400 River Pl , Braselton GA 30517-5600. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Pendem, Shanthan can be contacted via phone (770) 848-8000.

Contact Information

Primary practice address
1400 River Pl Braselton GA 30517-5600
Phone: (770) 848-8000
Fax: (770) 848-8601
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 9882 North Dakota
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 68271 Georgia

Profile Details

NPI number 1659425817
LBN Legal business name Pendem, Shanthan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2007
Last updated Oct 13th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659425817 NPPES
North Dakota Other P00256319 RR MEDICARE
North Dakota MEDICAID 13617 RR MEDICARE

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