Provider Demographics
NPI:1932358173
Name:BHAVARAJU, AVINASH (MD)
Entity type:Individual
Prefix:DR
First Name:AVINASH
Middle Name:
Last Name:BHAVARAJU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:AVI
Other - Middle Name:
Other - Last Name:BHAVARAJU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, DABS, FACS, FCCM
Mailing Address - Street 1:2451 CUMBERLAND PKWY SE STE 3821
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-6136
Mailing Address - Country:US
Mailing Address - Phone:404-668-2696
Mailing Address - Fax:
Practice Address - Street 1:2451 CUMBERLAND PKWY SE STE 3821
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-6136
Practice Address - Country:US
Practice Address - Phone:404-668-2696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-104702086S0127X
CAC1849632086S0102X, 2086S0127X
GA610432086S0127X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care