Provider Demographics
NPI:1104323203
Name:BHAVSAR, PARTH PARESHKUMAR (MBBS)
Entity type:Individual
Prefix:DR
First Name:PARTH
Middle Name:PARESHKUMAR
Last Name:BHAVSAR
Suffix:
Gender:
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 S PERRY ST STE 206
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4811
Mailing Address - Country:US
Mailing Address - Phone:678-956-1855
Mailing Address - Fax:
Practice Address - Street 1:3000 HOSPITAL BLVD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4915
Practice Address - Country:US
Practice Address - Phone:770-751-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA182278207Q00000X
MN1104323203207Q00000X
AZ66608207Q00000X
COCDR.0004739207Q00000X
IN01092359A207Q00000X
KYC2281207Q00000X
FLTPME5921.207Q00000X
IL036.160059207Q00000X
NV26878207Q00000X
LA340061207Q00000X
MIEMC0002968207Q00000X
MS30010207Q00000X
GA89053207Q00000X
AL43653207Q00000X
MN76379207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD487038COtherSTATE MEDICAL LICENSE
UT14197138-1235OtherSTATE MEDICAL LICENSE
OK41034OtherSTATE MEDICAL LICENSE
IA53469OtherSTATE MEDICAL LICENSE
NC320721OtherSTATE MEDICAL LICENSE
NJ25IA12513300OtherSTATE MEDICAL LICENSE
OH35C.001247OtherSTATE MEDICAL LICENSE
WA61644638OtherSTATE MEDICAL LICENSE
TN64681OtherSTATE MEDICAL LICENSE
SC89378OtherSTATE MEDICAL LICENSE
TXT6431OtherSTATE MEDICAL LICENSE
WI1605-320OtherSTATE MEDICAL LICENSE
MO2022047324OtherSTATE MEDICAL LICENSE