MEDICARE: DR. AVINASH BHAVARAJU M.D.

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	2086S0127X	Trauma Surgery Physician	E-10470	AR
2	2086S0102X	Surgical Critical Care Physician	C184963	CA
3	2086S0127X	Trauma Surgery Physician	61043	GA
4	2086S0102X	Surgical Critical Care Physician	61043	GA
5	2086S0127X	Trauma Surgery Physician	C184963	CA

General Provider Information

NPI Number	:	1932358173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AVINASH BHAVARAJU M.D.

Provider Business Mailing Address
First Line	:	2451 CUMBERLAND PKWY SE STE 3821
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-6136
Country	:	US
Telephone Number	:	404-668-2696
Fax Number	:

Provider Business Practice Location Address
First Line	:	2451 CUMBERLAND PKWY SE STE 3821
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-6136
Country	:	US
Telephone Number	:	404-668-2696
Fax Number	:

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

Provider Enumeration Date	:	09/11/2008
Last Update Date	:	12/03/2025

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