Provider Demographics
NPI:1760529523
Name:KHURANA, RUCHIR K (MD)
Entity Type:Individual
Prefix:DR
First Name:RUCHIR
Middle Name:K
Last Name:KHURANA
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 1:551 RIVERSTONE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-5292
Mailing Address - Country:US
Mailing Address - Phone:770-345-2000
Mailing Address - Fax:
Practice Address - Street 1:551 RIVERSTONE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-5292
Practice Address - Country:US
Practice Address - Phone:770-345-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2013-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT041812207P00000X
IA38440207P00000X
GA53772207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H94582Medicare UPIN
CTP00405414Medicare PIN
CT930000978Medicare PIN