Individual
RAJ KUMAR BANSAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
870 CRESTMARK DR, STE 201, LITHIA SPRINGS, GA 30122
(770) 739-5242
(770) 739-5204
Mailing address
870 CRESTMARK DR, STE 201, LITHIA SPRINGS, GA 30122
(770) 739-5242
(770) 739-5204
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
048412
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00864421E
—
GA
Enumeration date
02/08/2006
Last updated
03/24/2016
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