Provider Demographics
NPI:1174747919
Name:DINESH K BHATIA MD PC
Entity type:Organization
Organization Name:DINESH K BHATIA MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-380-5010
Mailing Address - Street 1:1000 WHITLOCK AVE NW STE 320 PMB 290
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-5449
Mailing Address - Country:US
Mailing Address - Phone:770-380-5010
Mailing Address - Fax:770-528-6019
Practice Address - Street 1:550 PEACHTREE ST NE STE 1135
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2234
Practice Address - Country:US
Practice Address - Phone:404-875-9636
Practice Address - Fax:404-815-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP7577Medicare ID - Type UnspecifiedGROUP MEDICARE GA