Provider Demographics
NPI:1851749378
Name:BRAHMBHATT, SUMIR MUKESH (MD)
Entity Type:Individual
Prefix:DR
First Name:SUMIR
Middle Name:MUKESH
Last Name:BRAHMBHATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6002 PROFESSIONAL PKWY STE 280
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-5627
Mailing Address - Country:US
Mailing Address - Phone:770-333-2035
Mailing Address - Fax:770-999-2842
Practice Address - Street 1:6002 PROFESSIONAL PKWY STE 280
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-5627
Practice Address - Country:US
Practice Address - Phone:770-333-2035
Practice Address - Fax:770-999-2842
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ58787207RR0500X
GA93723207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIVAD000Medicare UPIN