Organization
DANWANTRY MEDICAL & IMAGING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAGHAVA A. BHASKARAN M.D. (PHYSICIAN)
(478) 998-1471
Entity
Organization
Contact information
Practice address
4961 BUFORD HWY, SUITE 102, CHAMBLEE, GA 30341-3503
(478) 998-1471
Mailing address
PO BOX 1527, DUBLIN, GA 31040-1527
(478) 274-1100
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
025580
GA
2085N0904X
Nuclear Radiology Physician
025580
GA
2085R0202X
Diagnostic Radiology Physician
025580
GA
2085R0204X
Vascular & Interventional Radiology Physician
025580
GA
2085U0001X
Diagnostic Ultrasound Physician
025580
GA
208D00000X
General Practice Physician
Primary
025580
GA
Other
Enumeration date
05/21/2007
Last updated
11/23/2011
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