Healthcare Provider Details

I. General information

NPI: 1750419487
Provider Name (Legal Business Name): RANJANA SATYAMURTHY BHARGAVA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 12/01/2020
Certification Date: 12/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 KING AVE SUITE 200
ATHENS GA
30606-6734
US

IV. Provider business mailing address

1835 SAVOY DR SUITE 300
ATLANTA GA
30341-1072
US

V. Phone/Fax

Practice location:
  • Phone: 706-369-4478
  • Fax: 706-353-6639
Mailing address:
  • Phone: 706-369-4478
  • Fax: 706-353-6639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number068482
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: