Provider Demographics
NPI:1326086984
Name:BRAR, HARINDER S (MD)
Entity Type:Individual
Prefix:DR
First Name:HARINDER
Middle Name:S
Last Name:BRAR
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 1:157 NORTHWOODS DR NW
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-8260
Mailing Address - Country:US
Mailing Address - Phone:478-453-1015
Mailing Address - Fax:
Practice Address - Street 1:315 N COBB ST
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-2683
Practice Address - Country:US
Practice Address - Phone:478-453-0230
Practice Address - Fax:478-453-0940
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA033939174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00711114EMedicaid
GA33BDBDV01Medicare ID - Type Unspecified
GA00711114EMedicaid