Healthcare Provider Details

I. General information

NPI: 1972957470
Provider Name (Legal Business Name): HARIKA GORTI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2016
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 CLAIRMONT ROAD
DECATUR GA
30033
US

IV. Provider business mailing address

234 GOODMAN ST ML 0781
CINCINNATI OH
45219-2364
US

V. Phone/Fax

Practice location:
  • Phone: 404-321-6111
  • Fax:
Mailing address:
  • Phone: 513-584-4505
  • Fax: 513-584-0468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number57.028324
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number82804
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: