Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0129X | Vascular Surgeon | 35.136243 | OH |
Y | 2086S0129X | Vascular Surgeon | 79387 | GA |
NPI | 1053679126 |
---|---|
Provider Name | Barath Ram Badrinathan |
First Address | Decatur, GA 30033-6134 |
Second Address | Decatur, GA 30033-5918 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2012 |
Last Update Date | 07/10/2021 |