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Individual

DR. HILLERY BAVANI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
852 DACULA RD, DACULA, GA 30019-3185
(770) 848-9360
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0102203694
VA
207Q00000X
Family Medicine Physician
Primary
82342
GA
208M00000X
Hospitalist Physician
82342
GA

Other

Enumeration date
04/09/2014
Last updated
05/04/2021
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