Provider Demographics
NPI:1619180304
Name:AGHARKAR, BHUSHAN S (MD)
Entity type:Individual
Prefix:DR
First Name:BHUSHAN
Middle Name:S
Last Name:AGHARKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 EXECUTIVE PARK SOUTH NE
Mailing Address - Street 2:SUITE 360
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2288
Mailing Address - Country:US
Mailing Address - Phone:404-636-0054
Mailing Address - Fax:866-824-5215
Practice Address - Street 1:57 EXECUTIVE PARK SOUTH NE
Practice Address - Street 2:SUITE 360
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2288
Practice Address - Country:US
Practice Address - Phone:404-636-0054
Practice Address - Fax:866-824-5215
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA521862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry