Provider Demographics
NPI:1508211376
Name:BHATIA, RAVI DINESH (DO)
Entity Type:Individual
Prefix:
First Name:RAVI
Middle Name:DINESH
Last Name:BHATIA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 MONTE DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-2896
Mailing Address - Country:US
Mailing Address - Phone:404-808-9093
Mailing Address - Fax:
Practice Address - Street 1:260 HOSPITAL RD STE B
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-2409
Practice Address - Country:US
Practice Address - Phone:404-761-0819
Practice Address - Fax:770-528-6019
Is Sole Proprietor?:No
Enumeration Date:2016-04-29
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA89387207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology