Provider Demographics
NPI:1124090857
Name:HARJEE, GULSHAN S (MD)
Entity type:Individual
Prefix:
First Name:GULSHAN
Middle Name:S
Last Name:HARJEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2536 LAWRENCEVILLE HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033
Mailing Address - Country:US
Mailing Address - Phone:770-934-9832
Mailing Address - Fax:770-934-6337
Practice Address - Street 1:2536 LAWRENCEVILLE HWY
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3227
Practice Address - Country:US
Practice Address - Phone:770-934-6832
Practice Address - Fax:770-938-0837
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-06
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA026865207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000345463BMedicaid
GA00345463BMedicaid
GAD40061Medicare UPIN
GA00345463BMedicaid