MEDICARE: TIMOTHY NOSHI GHATTAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	046817	KS
2	207X00000X	Orthopaedic Surgery Physician	068163	GA

General Provider Information

NPI Number	:	1952507485
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY NOSHI GHATTAS MD

Provider Business Mailing Address
First Line	:	1919 SADLER DR SE
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30080-5845
Country	:	US
Telephone Number	:	979-574-4619
Fax Number	:

Provider Business Practice Location Address
First Line	:	33 UPPER RIVERDALE RD SW STE 121
Second Line	:
City	:	RIVERDALE
State	:	GA
Zip	:	30274-2642
Country	:	US
Telephone Number	:	404-323-4096
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2007
Last Update Date	:	02/17/2025

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Directions to “ TIMOTHY NOSHI GHATTAS MD” Practice Location

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