Provider Demographics
NPI:1063660223
Name:HARRIS, RASHANTE BASHINEKA (MD)
Entity Type:Individual
Prefix:MS
First Name:RASHANTE
Middle Name:BASHINEKA
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:882 PONCE DE LEON AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-4268
Mailing Address - Country:US
Mailing Address - Phone:770-809-3034
Mailing Address - Fax:404-347-9445
Practice Address - Street 1:882 PONCE DE LEON AVE NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-4268
Practice Address - Country:US
Practice Address - Phone:770-809-3034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-29
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAP62706207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA015655865AMedicaid
GA202I089383Medicare PIN