Provider Demographics
NPI:1891854592
Name:PARASHAR, SUSMITA (MD)
Entity Type:Individual
Prefix:
First Name:SUSMITA
Middle Name:
Last Name:PARASHAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUSMITA
Other - Middle Name:
Other - Last Name:MALLIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1365 CLIFTON ROAD NE
Mailing Address - Street 2:CLINIC A, SUITE 2200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322
Mailing Address - Country:US
Mailing Address - Phone:404-778-2746
Mailing Address - Fax:
Practice Address - Street 1:1365 CLIFTON ROAD
Practice Address - Street 2:EMORY UNIVERSITY
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322
Practice Address - Country:US
Practice Address - Phone:404-778-4931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA49242207R00000X
GA049242207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000880668AMedicaid
GAH23402Medicare UPIN
GA000880668AMedicaid