Provider Demographics
NPI:1073608899
Name:BHAT, ANNAPURNA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNAPURNA
Middle Name:
Last Name:BHAT
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 1:145 N PARK TRL
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7373
Mailing Address - Country:US
Mailing Address - Phone:770-389-1701
Mailing Address - Fax:770-389-9109
Practice Address - Street 1:145 N PARK TRL
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7373
Practice Address - Country:US
Practice Address - Phone:770-389-1701
Practice Address - Fax:770-389-9109
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031138207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA581985OtherBC/BS OF GA
GA00471259 AMedicaid
GA32 06116OtherUNITED HEALTHCARE
GA581954947001OtherCIGNA
GA4469392OtherAETNA
GA81831OtherCIGNA
GA81831OtherCIGNA
GAF 01473Medicare UPIN