Individual
DR. BAVANA KETHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5910 HILLANDALE DR STE 203, LITHONIA, GA 30058-1878
(404) 778-3712
Mailing address
5910 HILLANDALE DR STE 203, LITHONIA, GA 30058-1878
(404) 778-3712
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101275402
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
04/09/2015
Last updated
05/22/2023
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