Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 0101254093 | VA |
N | 2081P2900X | Pain Medicine | 0101254093 | VA |
N | 2081S0010X | Sports Medicine | 0101254093 | VA |
N | 213ES0000X | Sports Medicine | 0101254093 | VA |
NPI | 1144480989 |
---|---|
Provider Name | Dr. Niteesh Bharara |
First Address | Atlanta, GA 30384-4783 |
Second Address | Reston, VA 20191 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2008 |
Last Update Date | 24/07/2018 |