Individual
ROSANNA PURAN BAHADUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2799 LAWRENCEVILLE HWY, SUITE 104, DECATUR, GA 30033-2517
(678) 534-0200
(678) 534-0201
Mailing address
2799 LAWRENCEVILLE HWY, SUITE 104, DECATUR, GA 30033-2517
(678) 534-0200
(678) 534-0201
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
057772
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q0021C
—
SC
Enumeration date
07/06/2006
Last updated
07/08/2007
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