Healthcare Provider Details

I. General information

NPI: 1104385079
Provider Name (Legal Business Name): AVNI AMRATIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 HOWELL MILL RD NW STE 500
ATLANTA GA
30318-2594
US

IV. Provider business mailing address

1800 HOWELL MILL RD NW STE 500
ATLANTA GA
30318-2594
US

V. Phone/Fax

Practice location:
  • Phone: 404-367-3350
  • Fax:
Mailing address:
  • Phone: 404-367-3350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number99830
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberU8935
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number99830
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: