Provider Demographics
NPI:1508818147
Name:BENDI, INDUMATHI (MD)
Entity Type:Individual
Prefix:DR
First Name:INDUMATHI
Middle Name:
Last Name:BENDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 COLLIER RD NW
Mailing Address - Street 2:SUITE 1030
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1710
Mailing Address - Country:US
Mailing Address - Phone:404-350-3860
Mailing Address - Fax:404-609-7660
Practice Address - Street 1:105 COLLIER RD NW
Practice Address - Street 2:SUITE 1030
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1710
Practice Address - Country:US
Practice Address - Phone:404-350-3860
Practice Address - Fax:404-609-7660
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA057282207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA950505757AMedicaid
GAI20664Medicare UPIN
GA11SCGDTMedicare ID - Type Unspecified