MEDICARE: DR. SUBRAHMANYA BHAT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	30576	GA
2	207R00000X	Internal Medicine Physician	30576	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	76802	OTHER	GA	CIGNA
2	0402771	OTHER	GA	UNITED HEALTHCARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	4460389	OTHER	GA	AETNA
5	582368657001	OTHER	GA	CIGNA
6	983300	OTHER	GA	BC/BS OF GA

General Provider Information

NPI Number	:	1164517967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUBRAHMANYA BHAT MD

Provider Business Mailing Address
First Line	:	145 N PARK TRL
Second Line	:
City	:	STOCKBRIDGE
State	:	GA
Zip	:	30281-7373
Country	:	US
Telephone Number	:	770-389-1703
Fax Number	:	770-389-9109

Provider Business Practice Location Address
First Line	:	145 N PARK TRL
Second Line	:
City	:	STOCKBRIDGE
State	:	GA
Zip	:	30281-7373
Country	:	US
Telephone Number	:	770-389-1703
Fax Number	:	770-389-9109

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	03/19/2026

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Directions to “ DR. SUBRAHMANYA BHAT MD” Practice Location

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