Provider Demographics
NPI:1962528257
Name:BRAHMA, PAVNA MADHAVI (MD)
Entity type:Individual
Prefix:DR
First Name:PAVNA
Middle Name:MADHAVI
Last Name:BRAHMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PAVNA
Other - Middle Name:MADHAVI
Other - Last Name:KARTHA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9600 BLACKWELL ROAD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850
Mailing Address - Country:US
Mailing Address - Phone:301-340-1188
Mailing Address - Fax:404-257-0792
Practice Address - Street 1:5445 MERIDIAN MARK ROAD
Practice Address - Street 2:SUITE 270
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342
Practice Address - Country:US
Practice Address - Phone:404-843-2229
Practice Address - Fax:404-257-0792
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA59607207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology