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Individual

DR. DASHAWN BAKARI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6584 PROFESSIONAL PL, SUITE A, RIVERDALE, GA 30274-4942
(770) 477-1115
(770) 477-1119
Mailing address
PO BOX 190306, ATLANTA, GA 31119-0306
(770) 477-1115
(770) 477-1119

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2257
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
032883905C
GA
01
27-0821510
TRICARE
GA
01
3094116
UNITED HEALTHCARE
GA
01
52463639-003
BLUE CROSS BLUE SHIELD
GA
01
9065421
AETNA
GA
01
9752079
CIGNA
GA
Enumeration date
01/30/2008
Last updated
05/04/2016
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