Individual
BANTWAL PRATHIBHA BALIGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD,DGO
Contact information
Practice address
1400 BRADLEY LAKE BLVD, COLUMBUS, GA 31904
(706) 507-2050
(706) 507-2059
Mailing address
1400 BRADLEY LAKE BLVD, COLUMBUS, GA 31904
(706) 507-2050
(706) 507-2059
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
056683
GA
Other
Enumeration date
10/02/2006
Last updated
10/12/2012
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