Provider Demographics
NPI:1073698999
Name:BHATTI, HARVINDER S (MD)
Entity Type:Individual
Prefix:DR
First Name:HARVINDER
Middle Name:S
Last Name:BHATTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1288 WELLBROOK CIR NE STE A
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-8032
Mailing Address - Country:US
Mailing Address - Phone:678-369-6934
Mailing Address - Fax:
Practice Address - Street 1:1288 WELLBROOK CIR NE STE A
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-8032
Practice Address - Country:US
Practice Address - Phone:678-369-6934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25-28056207X00000X
GA065733207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003110463AMedicaid
GA202I205121Medicare PIN