Provider Demographics
NPI:1174641898
Name:NORTH ATLANTA HEART AND VASCULAR CENTER PC
Entity Type:Organization
Organization Name:NORTH ATLANTA HEART AND VASCULAR CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BHASKAR
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-887-3255
Mailing Address - Street 1:1400 NORTHSIDE FORSYTH DRIVE
Mailing Address - Street 2:SUITE 380
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6018
Mailing Address - Country:US
Mailing Address - Phone:770-887-3255
Mailing Address - Fax:
Practice Address - Street 1:1400 NORTHSIDE FORSYTH DR STE 380
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6018
Practice Address - Country:US
Practice Address - Phone:770-887-3255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA179889687AMedicaid
GAGRP6931Medicare ID - Type Unspecified