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General NPI Number Information
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NPI Number | 1760554703
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Entity Type | Individual
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Provider Name | ANWER ALI SHAMSUDDIN BHAMANI M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 1364 CLIFTON RD NE STE N-305
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City | ATLANTA
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State | GA
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Zip | 30322-6342
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Country | US
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Telephone | 404-778-5334
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Fax | 404-778-4181
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Provider Business Mailing Address
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Address Line | 3165 SAINT IVES COUNTRY CLUB PKWY
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City | DULUTH
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State | GA
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Zip | 30097-2001
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Country | US
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Telephone | 770-880-1774
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Fax | 770-502-6754
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 55391
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License Number State | GA
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