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General NPI Number Information
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NPI Number | 1104433382
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Entity Type | Individual
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Provider Name | ADITI BHATTACHARJEE SUNDARESAN PA-C, MPH
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Gender | Female
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Dates
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Enumeration Date | 09/30/2020
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Last Update Date | 10/20/2021
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Provider Practice Location Address
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Address Line | 2801 N DECATUR RD STE 295
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City | DECATUR
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State | GA
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Zip | 30033-5936
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Country | US
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Telephone | 404-778-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 2801 N DECATUR RD STE 295
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City | DECATUR
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State | GA
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Zip | 30033-5936
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Country | US
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Telephone | 404-778-6400
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-10656
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10525
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License Number State | GA
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