Provider Demographics
NPI:1295898880
Name:ATLANTA REHABILITATION CONSULTANTS PC
Entity type:Organization
Organization Name:ATLANTA REHABILITATION CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BHOLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-673-0308
Mailing Address - Street 1:8953 OLD SOUTHWICK PASS
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-7140
Mailing Address - Country:US
Mailing Address - Phone:770-664-7379
Mailing Address - Fax:770-558-6798
Practice Address - Street 1:3215 MCCLURE BRIDGE RD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3223
Practice Address - Country:US
Practice Address - Phone:678-584-6786
Practice Address - Fax:678-584-6719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA24513208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP4237Medicare ID - Type Unspecified