Provider Demographics
NPI:1013443381
Name:NORTH ATLANTA HEART & VASCULAR CENTRE
Entity Type:Organization
Organization Name:NORTH ATLANTA HEART & VASCULAR CENTRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BHASKAR
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-887-3255
Mailing Address - Street 1:PO BOX 809
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-0809
Mailing Address - Country:US
Mailing Address - Phone:470-297-6702
Mailing Address - Fax:
Practice Address - Street 1:960 SANDERS RD STE 700
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6058
Practice Address - Country:US
Practice Address - Phone:770-887-3255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH ATLANTA HEART & VASCULAR CENTRE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-05
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA179889687AMedicaid
GAGRP6931Medicare PIN