Provider Demographics
NPI:1033314422
Name:GANDHI, PEAHEN (MD)
Entity type:Individual
Prefix:DR
First Name:PEAHEN
Middle Name:
Last Name:GANDHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11681 HAYNES BRIDGE RD STE 302
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-2646
Mailing Address - Country:US
Mailing Address - Phone:470-458-9705
Mailing Address - Fax:470-458-9706
Practice Address - Street 1:11681 HAYNES BRIDGE RD STE 302
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-2646
Practice Address - Country:US
Practice Address - Phone:470-458-9705
Practice Address - Fax:470-458-9706
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA57169207VF0040X
GA057169207VX0000X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA057169OtherGEORGIA STATE LICENSES
GA616316896EMedicaid
GA616316896AMedicaid
GA16BBDLXOtherMEDICARE
GA616316896CMedicaid
GA616316896DMedicaid
GA616316896DMedicaid