Provider Demographics
NPI:1841633807
Name:BHATNAGAR, SUDARSHANA SONA (MD)
Entity type:Individual
Prefix:
First Name:SUDARSHANA
Middle Name:SONA
Last Name:BHATNAGAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SONA SUDARSHANA
Other - Middle Name:
Other - Last Name:GORE-BHATNAGAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1712 HABERSHAM VILLA DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-8630
Mailing Address - Country:US
Mailing Address - Phone:301-512-8741
Mailing Address - Fax:
Practice Address - Street 1:1712 HABERSHAM VILLA DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-8630
Practice Address - Country:US
Practice Address - Phone:301-512-8741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-09
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0044582207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine