DR. POOJA BARDHAN (NPI# 1962601344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962601344 |
| Entity Type | Individual |
| Full Name | DR. POOJA BARDHAN |
| Credential | MD |
| Practice Address |
790 Church St Ne Suite 335 Marietta GA 30060-7282 |
| Mailing Address |
1835 Savoy Dr Suite 300 Atlanta GA 30341-1072 |
| Practice Telephone | 7705908311 |
| Practice Fax Number | 7705908313 |
| Mailing Telephone | 7705908311 |
| Mailing Fax Number | 7705908313 |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2020-08-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
075738 | GA | Allopathic & Osteopathic Physicians |
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
0101248148 | VA | Allopathic & Osteopathic Physicians |
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
TRN11073 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003175923B | 05 | |
| GA | 003175923A | 05 |
| Street Address |
790 CHURCH ST NE SUITE 335 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-7282 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720083702 | Roberto A. Larrivey | Otolaryngology | 790 Church St Ne, Ste 140, Marietta, GA 30060-8902 | 2005-06-16 |
| 1003356361 | Proactive Physicians of Marietta, PC | Clinic/Center | 790 Church St Ne, Suite 220, Marietta, GA 30060-7282 | 2017-03-06 |
| 1720535529 | Tracy Zoblisein | Pharmacist | 790 Church St Ne, Suite 335, Marietta, GA 30060-7282 | 2016-09-09 |
| 1609323641 | Lisa Long | Pharmacist | 790 Church St Ne, Suite 335, Marietta, GA 30060-7282 | 2016-09-07 |
| 1306293113 | Kristina L Thomas | Nurse Practitioner | 790 Church St Ne, Suite 150, Marietta, GA 30060-7282 | 2016-05-21 |
| 1447681218 | James Wesley Garrett | Physician Assistant | 790 Church St Ne, Ste 400, Marietta, GA 30060-7282 | 2013-12-04 |
| 1396083606 | Deborah Luann Hurd | Nurse Practitioner | 790 Church St Ne, Suite 330, Marietta, GA 30060-7282 | 2013-01-21 |
| 1336485457 | Paradigm Medical LLC | Specialist | 790 Church St Ne, Suite 410, Marietta, GA 30060-7282 | 2012-12-18 |
| 1679824742 | Nsh Cancer Institute Professional Services G LLC | Durable Medical Equipment & Medical Supplies | 790 Church St Ne, Suite 335, Marietta, GA 30060-7282 | 2012-09-28 |
| 1568724052 | Brandon M Paritz | Family Medicine | 790 Church St Ne, Suite 250, Marietta, GA 30060-7282 | 2012-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245234608 | Michael B Andrews | Internal Medicine | 340 Kennestone Hospital Blvd Ste 100, Marietta, GA 30060-1158 | 2005-06-13 |
| 1427321124 | Shuang Yin Zhang | Internal Medicine | 340 Kennestone Hospital Blvd, Suite 200, Marietta, GA 30060-1173 | 2012-02-12 |
| 1689990061 | John Thomas French | Internal Medicine | 340 Kennestone Hospital Blvd Ste 100, Marietta, GA 30060-1158 | 2010-04-11 |
| 1982823290 | Devaki Siva | Internal Medicine | 400 Matthew St, Strecker Cancer Center, Marietta, OH 45750-1644 | 2007-04-25 |
| 1609941335 | Louis C Garrot | Internal Medicine | 790 Church St Ne, Suite 335, Marietta, GA 30060-7282 | 2006-11-21 |
| 1023113727 | Kelli A Cawley | Internal Medicine | 400 Matthew St, Strecker Cancer Center, Marietta, OH 45750 | 2006-09-14 |
| 1194829721 | Mukund K Shah | Internal Medicine | 400 Matthew St, Strecker Cancer Center, Marietta, OH 45750-1644 | 2006-09-12 |
| 1598871410 | Carmen Manuela Klass | Internal Medicine | 340 Kennestone Hospital Blvd Ste 100, Marietta, GA 30060-1158 | 2006-08-22 |
| 1902811623 | Georgia Cancer Specialists I PC | Internal Medicine | 340 Kennestone Hospital Blvd, Suite 100, Marietta, GA 30060-1152 | 2006-07-30 |
| 1497711931 | Madhurima Uppalapati | Internal Medicine | 340 Kennestone Hospital Blvd Ste 100, Marietta, GA 30060-1158 | 2006-04-25 |
| Find all providers in MARIETTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.