Provider Demographics
NPI:1215439286
Name:HUBLIKAR, SWARAJ SUHAS (PA-C)
Entity type:Individual
Prefix:
First Name:SWARAJ
Middle Name:SUHAS
Last Name:HUBLIKAR
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 HIGHWAY 34 E STE 1200
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-6416
Mailing Address - Country:US
Mailing Address - Phone:888-341-3360
Mailing Address - Fax:
Practice Address - Street 1:2050 JONESBORO RD STE A
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253
Practice Address - Country:US
Practice Address - Phone:678-935-0090
Practice Address - Fax:678-935-0095
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL008691363A00000X
GA8691363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant