Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 051294 | GA |
NPI | 1013916576 |
---|---|
Provider Name | Dr. Akhil Baranwal |
First Address | Douglas, GA 31533-3409 |
Second Address | Douglas, GA 31533-3409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 26/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00964697A | (05) | GA |
H62976 | (02) | GA |