Healthcare Provider Details

I. General information

NPI: 1144831595
Provider Name (Legal Business Name): ABHINANDAN RAVINDRA CHITTAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2020
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 COLLIER RD NW STE 300
ATLANTA GA
30309-1740
US

IV. Provider business mailing address

201 E UNIVERSITY PKWY DEPT OF
BALTIMORE MD
21218-2829
US

V. Phone/Fax

Practice location:
  • Phone: 404-350-0009
  • Fax:
Mailing address:
  • Phone: 410-554-2284
  • Fax: 410-554-2184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number111993
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: