Provider Demographics
NPI:1649457029
Name:EMORY UNIVERSITY SCHOOL OF MEDICINE
Entity type:Organization
Organization Name:EMORY UNIVERSITY SCHOOL OF MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUNA
Authorized Official - Middle Name:HATTI
Authorized Official - Last Name:GOKHALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-285-8793
Mailing Address - Street 1:69 JESSE HILL JR DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-3033
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:69 JESSE HILL JR DR SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3033
Practice Address - Country:US
Practice Address - Phone:404-616-7024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002753282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA002753OtherLICENSE NUMBER