Ketha, Bavana

Ketha, Bavana is an sole proprietor health care provider with primary practice located at 5910 Hillandale Dr Ste 203 , Lithonia GA 30058-1878. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is her primary health care specialty. Ketha, Bavana can be contacted via phone (404) 778-3712.

Contact Information

Primary practice address
5910 Hillandale Dr Ste 203 Lithonia GA 30058-1878
Phone: (404) 778-3712
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Surgery 208600000X 0101275402 Virginia

Profile Details

NPI number 1164818969
LBN Legal business name Ketha, Bavana
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 9th, 2015
Last updated May 22nd, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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