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General NPI Number Information
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NPI Number | 1124337506
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Entity Type | Organization
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Legal Business Name | WEST ATLANTA OB-GYN INC
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Dates
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Enumeration Date | 10/01/2010
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Last Update Date | 10/01/2010
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Provider Practice Location Address
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Address Line | 3610 HIGHLANDS PKWY SE
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City | SMYRNA
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State | GA
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Zip | 30082-5184
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Country | US
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Telephone | 770-444-9981
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Fax | 770-444-9970
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Provider Business Mailing Address
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Address Line | 3610 HIGHLANDS PKWY SE
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City | SMYRNA
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State | GA
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Zip | 30082-5184
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Country | US
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Telephone | 770-444-9981
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Fax | 770-444-9970
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Authorized Official
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Title or Position | MD/OWNER
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Name | DR. KALPANA RAGHAVAN
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Credential | MD
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Telephone | 770-444-9981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 038920
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License Number State | GA
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