Individual
BHAWNA KHANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3950 COBB PARKWAY NW, SUITE 601, ACWORTH, GA 30101-9530
(770) 874-7623
(770) 874-7627
Mailing address
3950 COBB PARKWAY NW, SUITE 601, ACWORTH, GA 30101-9530
(770) 874-7623
(770) 874-7627
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
050310
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11SCGRF
MEDICARE PIN
GA
01
—
H42360
MEDICARE UPIN
GA
Enumeration date
10/27/2005
Last updated
11/27/2012
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