Provider Demographics
NPI:1386670271
Name:LALANI, HUSHEN HABIBBHAI (MD)
Entity Type:Individual
Prefix:
First Name:HUSHEN
Middle Name:HABIBBHAI
Last Name:LALANI
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 1:1309,MILSTEAD ROAD NE,STE B
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-3874
Mailing Address - Country:US
Mailing Address - Phone:770-761-0492
Mailing Address - Fax:770-761-0972
Practice Address - Street 1:1309,MILSTEAD ROAD NE,STE B
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-3874
Practice Address - Country:US
Practice Address - Phone:770-761-0492
Practice Address - Fax:770-761-0972
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA046983208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA046983OtherGA LICENSE NUMBER PHYSICI
BL4600828OtherDEA NUMBER