Raj Kumar Bansal, MD | |
870 Crestmark Dr, Ste 201, Lithia Springs, GA 30122 | |
(770) 739-5242 | |
(770) 739-5204 |
Full Name | Raj Kumar Bansal |
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Gender | Male |
Speciality | Obstetrics & Gynecology - Maternal & Fetal Medicine |
Location | 870 Crestmark Dr, Lithia Springs, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1386617603 | NPI | - | NPPES |
00864421E | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207VM0101X | Obstetrics & Gynecology - Maternal & Fetal Medicine | 048412 (Georgia) | Primary |
Entity Name | Obstetrix Medical Group Of Atlanta, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396970109 PECOS PAC ID: 8527105253 Enrollment ID: O20091028000490 |
Mailing Address | Practice Location Address |
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Raj Kumar Bansal, MD 870 Crestmark Dr, Ste 201, Lithia Springs, GA 30122 Ph: (770) 739-5242 | Raj Kumar Bansal, MD 870 Crestmark Dr, Ste 201, Lithia Springs, GA 30122 Ph: (770) 739-5242 |
Suzanne Lee Lowry, M.D. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 939 Bob Arnold Blvd, Suite A, Lithia Springs, GA 30122 Phone: 770-732-2959 Fax: 770-732-2947 | |
Dr. Lisa Ortenzi, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 880 Crestmark Dr, Suite 200, Lithia Springs, GA 30122 Phone: 770-941-8662 Fax: 770-739-6006 | |
Jeffrey A Bradley, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 870 Crestmark Dr Ste 203, Lithia Springs, GA 30122 Phone: 470-881-8757 | |
Linda Dianne Ford, M.D. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 939 Bob Arnold Blvd, Suite A, Lithia Springs, GA 30122 Phone: 770-944-9852 Fax: 770-944-1043 |