Provider Demographics
NPI:1942345442
Name:PARBHU, BEENA R (MD)
Entity Type:Individual
Prefix:MRS
First Name:BEENA
Middle Name:R
Last Name:PARBHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6095 PROFESSIONAL PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-5607
Mailing Address - Country:US
Mailing Address - Phone:770-920-2255
Mailing Address - Fax:770-920-9963
Practice Address - Street 1:3747 ROSWELL RD STE 201
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-6227
Practice Address - Country:US
Practice Address - Phone:770-578-2868
Practice Address - Fax:770-971-8499
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY41601208000000X
FLME104615208000000X
GA67713208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003128452AMedicaid
FLME 104615OtherMEDICAL STATE LICENSE
KY7100047720Medicaid
GA003128452ACMedicaid
IN200907860Medicaid
IN200907860Medicaid