Healthcare Provider Details

I. General information

NPI: 1265430904
Provider Name (Legal Business Name): SEEMA BISHT-NADLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date: 03/21/2006
Reactivation Date: 03/28/2006

III. Provider practice location address

3030 MCEVER RD STE 130
GAINESVILLE GA
30504-5538
US

IV. Provider business mailing address

3030 MCEVER RD STE 130
GAINESVILLE GA
30504-5538
US

V. Phone/Fax

Practice location:
  • Phone: 678-450-0747
  • Fax: 678-450-0779
Mailing address:
  • Phone: 678-450-0747
  • Fax: 678-450-0779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number046361
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number246361
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number046361
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: