MEDICARE: DR. BHARATI B GANDHI 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	208100000X	Physical Medicine & Rehabilitation Physician	021394	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992918858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BHARATI B GANDHI MD

Provider Business Mailing Address
First Line	:	4553 N SHALLOWFORD RD
Second Line	:	SUITE 70 C
City	:	ATLANTA
State	:	GA
Zip	:	30338-6408
Country	:	US
Telephone Number	:	770-455-3060
Fax Number	:	770-455-3061

Provider Business Practice Location Address
First Line	:	4553 N SHALLOWFORD RD
Second Line	:	SUITE 70 C
City	:	ATLANTA
State	:	GA
Zip	:	30338-6408
Country	:	US
Telephone Number	:	770-455-3060
Fax Number	:	770-455-3061

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

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	07/08/2007

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