Provider Demographics
NPI:1902025596
Name:BHALANI, VISHAL (MD)
Entity Type:Individual
Prefix:DR
First Name:VISHAL
Middle Name:
Last Name:BHALANI
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 1:960 SANDERS RD STE 500
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-5978
Mailing Address - Country:US
Mailing Address - Phone:678-321-7227
Mailing Address - Fax:
Practice Address - Street 1:960 SANDERS RD STE 500
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-5978
Practice Address - Country:US
Practice Address - Phone:678-321-7227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125053804208800000X
GA074749208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology