Basic Information
Provider Information
NPI: 1770600181
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BHIMANI
FirstName: ASHISH
MiddleName: AMBAVI
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 275 COLLIER RD NW
Address2: SUITE 500
City: ATLANTA
State: GA
PostalCode: 303091709
CountryCode: US
TelephoneNumber: 4046052800
FaxNumber: 4043515983
Practice Location
Address1: 275 COLLIER RD NW
Address2: SUITE 500
City: ATLANTA
State: GA
PostalCode: 303091709
CountryCode: US
TelephoneNumber: 4046052800
FaxNumber: 4043515983
Other Information
ProviderEnumerationDate: 03/23/2007
LastUpdateDate: 10/31/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0001X076776GAY Allopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology

No ID Information.


Home