Healthcare Provider Details

I. General information

NPI: 1215863014
Provider Name (Legal Business Name): REDPEARMD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3194 BUFORD HWY STE 100
DULUTH GA
30096-3386
US

IV. Provider business mailing address

3194 BUFORD HWY STE 100
DULUTH GA
30096-3386
US

V. Phone/Fax

Practice location:
  • Phone: 404-490-0754
  • Fax: 678-712-4389
Mailing address:
  • Phone: 404-490-0754
  • Fax: 678-712-4389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PURNIMA BANSAL
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 404-490-0754