Provider Demographics
NPI:1134281199
Name:KHURANA, RITU KUMARI (MD)
Entity Type:Individual
Prefix:
First Name:RITU
Middle Name:KUMARI
Last Name:KHURANA
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 1:221 TECHNOLOGY PKWY NW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-1369
Mailing Address - Country:US
Mailing Address - Phone:762-235-1000
Mailing Address - Fax:
Practice Address - Street 1:19 REDMOND RD NW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1533
Practice Address - Country:US
Practice Address - Phone:706-233-8504
Practice Address - Fax:706-233-8505
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055858207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA678012706DMedicaid
GA678012706AMedicaid
GA678012706BMedicaid
GA678012706CMedicaid
GA678012706EMedicaid
GA678012706BMedicaid
GA678012706AMedicaid