Healthcare Provider Details

I. General information

NPI: 1245302124
Provider Name (Legal Business Name): ARVIND MANUBHAI GADHIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 JESSE HILL JR DR SE
ATLANTA GA
30303
US

IV. Provider business mailing address

105 JEFFERSON WOODS DR
PEACHTREE CITY GA
30269-4116
US

V. Phone/Fax

Practice location:
  • Phone: 404-730-1415
  • Fax: 404-730-1499
Mailing address:
  • Phone: 770-487-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number19682
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: