Healthcare Provider Details

I. General information

NPI: 1942763974
Provider Name (Legal Business Name): NITA BHAT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 HOWELL MILL RD NW STE 321
ATLANTA GA
30327-4109
US

IV. Provider business mailing address

3280 HOWELL MILL RD NW STE 321
ATLANTA GA
30327-4109
US

V. Phone/Fax

Practice location:
  • Phone: 404-946-8323
  • Fax:
Mailing address:
  • Phone: 404-946-8323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number111021
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number59107
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number59107
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number111021
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: