Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 003000 | GA |
N | 208600000X | Surgeon | 003000 | GA |
Y | 208200000X | Surgeon | 440460 | SC |
Y | 208600000X | Surgeon | 440460 | SC |
N | 2086S0120X | Pediatric Surgery | 440460 | SC |
NPI | 1447412127 |
---|---|
Provider Name | Dr. Varun Kumar Bhalla |
First Address | Atlanta, GA 30374-3904 |
Second Address | Columbia, SC 29203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2008 |
Last Update Date | 02/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
404609 | (05) | SC |