MR. GAUTAM JAGOO (NPI# 1124092986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124092986 |
| Entity Type | Individual |
| Full Name | MR. GAUTAM JAGOO |
| Credential | MD |
| Practice Address |
1700 Medical Way Snellville GA 30078-2195 |
| Mailing Address |
2225 Sundown Dr Ne Atlanta GA 30345-3552 |
| Practice Telephone | 7709790200 |
| Mailing Telephone | 4048054947 |
| Mailing Fax Number | 4045015707 |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
05601 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
1700 MEDICAL WAY |
| City | SNELLVILLE |
| State | GA |
| Zip Code | 30078-2195 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568467447 | Edwin W Nunnery Jr. | Pathology | 1700 Medical Way, Snellville, GA 30078-2195 | 2005-06-16 |
| 1871193037 | Olakemi L Adenuga | Registered Nurse | 1700 Medical Way, Snellville, GA 30078-2195 | 2020-10-27 |
| 1922625102 | Fiji George | Pharmacist | 1700 Medical Way, Snellville, GA 30078-2195 | 2020-07-03 |
| 1033738349 | Kathryn Iwasaki | Physician Assistant | 1700 Medical Way, Snellville, GA 30078-2195 | 2020-04-16 |
| 1669005880 | Sarah Marlene Anderson | Nurse Practitioner | 1700 Medical Way, Snellville, GA 30078-2195 | 2020-02-17 |
| 1942866926 | Samantha Alice Stellmacher | Physician Assistant | 1700 Medical Way, Snellville, GA 30078-2195 | 2019-05-15 |
| 1205316189 | Stephanie Alyse Powell | Anesthesiologist Assistant | 1700 Medical Way, Anesthesia Department, Snellville, GA 30078 | 2018-08-20 |
| 1053899724 | Micheal Tyrone Wright | Nurse Practitioner | 1700 Medical Way, Snellville, GA 30078-2195 | 2018-08-03 |
| 1083120588 | Andrea M Kennedy | Specialist/Technologist, Other | 1700 Medical Way, Snellville, GA 30078-2195 | 2017-12-19 |
| 1861848210 | Umair Rahim Shaikh | Internal Medicine | 1700 Medical Way, Snellville, GA 30078-2195 | 2016-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619594561 | Steven Nguyen | Optometrist | 1905 Scenic Hwy S #1130, Snellville, GA 30078 | 2020-06-26 |
| 1891320776 | Youstina Harkas | Optometrist | 1679 Scenic Hwy S 203, Snellville, GA 30078 | 2020-03-11 |
| 1578101127 | Jwwt Neuoromonitoring, LLC | Psychiatry & Neurology | 1350 Scenic Highway, Suite 266, Snelville, GA 30078 | 2019-12-13 |
| 1679119903 | Lashon Poole Wells | Social Worker | 1350 Scenic Highway Ste 266, 1350 Scenic Highway Ste 266, Snellville, GA 30078 | 2019-11-21 |
| 1427601426 | Aemad Heavenly Joy Senior Homecare & Developmental Disabilities LLC | Registered Nurse | 1350 Scenic Highway Suite #266, Sneville, GA 30078 | 2019-07-18 |
| 1063975548 | Joanne Mcdougal Patterson | Nurse Practitioner | 1350 Scenic Hwy N Ste 226, Snellville, GA 30078 | 2019-04-10 |
| 1689144263 | Israel Branford | Physical Therapist | 1575 Scenic Hwy Ste 100, Snellville, GA 30078 | 2018-11-27 |
| 1902382997 | Brittany Dupree | Dermatology | 2383 Pate Street North, Snellville, GA 30078 | 2018-07-13 |
| 1134610926 | Reid Weston Popple | Dentist | 2992 Stone Mountain Hwy, A100, Snellville, GA 30078 | 2018-05-29 |
| 1326550492 | Optimal Healthcare Services LLC | Clinic/Center | 2121 Fountain Dr Ste F, Snellville, GA 30078 | 2017-10-30 |
| Find all providers in zip 30078 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194706606 | Northwest Diagnostic Imaging, Inc | Radiology | 1608 Tree Ln, Building D Suite 400, Snellville, GA 30078-2399 | 2005-11-10 |
| 1215258231 | Arvind Sivakumaran | Radiology | 1700 Medical Way, Snellville, GA 30078-2195 | 2010-06-14 |
| 1871726950 | Open Mri of Georgia, Inc | Radiology | 1608 Tree Ln, Suite 400, Snellville, GA 30078-2399 | 2009-08-24 |
| 1477729051 | Michael Robert Aho | Radiology | 1700 Medical Way, Snellville, GA 30078-2195 | 2008-05-05 |
| 1740232677 | South Gwinnett Radiology PC | Radiology | 1700 Medical Way, Snellville, GA 30078 | 2006-05-17 |
| 1043284615 | Charlotte A Hayes | Radiology | 1700 Medical Way, Snellville, GA 30078-2195 | 2006-02-13 |
| 1619949773 | Shailaja R. Sappati | Radiology | 1700 Medical Way, Snellville, GA 30078-2195 | 2006-02-03 |
| 1306822192 | Robert J Kubek | Radiology | 1700 Medical Way, Snellville, GA 30078-2195 | 2005-12-22 |
| 1538145529 | Gregory S. Berkey | Radiology | 1700 Medical Way, Snellville, GA 30078-2195 | 2005-12-21 |
| 1629054622 | Beth D Kruse | Radiology | 1700 Medical Way, Snellville, GA 30078-2195 | 2005-12-21 |
| Find all providers in SNELLVILLE | ||||
| City | SNELLVILLE |
| Zip Code | 30078 |
Please comment or provide details below to improve the information on MR. GAUTAM JAGOO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.