Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 82537 | GA |
NPI | 1043639545 |
---|---|
Provider Name | Meghana Bhatta Kumar |
First Address | Decatur, GA 30030-4482 |
Second Address | Conyers, GA 30012-3838 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2014 |
Last Update Date | 29/06/2020 |