Vidal Bakshi, CST, CSFA

Individual provider Active NPI Surgical Assistant · Johns Creek, GA

NPI 1982302386 · NPPES record last updated Apr 28, 2023

Key facts

NPI
1982302386
Entity type
Individual (NPI type 1)
Primary specialty
Surgical Assistant 246ZC0007X
License
215334 (GA)
Practice address
6325 Hospital Pkwy
Johns Creek, GA 30097-5775
Phone
(678) 474-7000
NPI assigned
Feb 16, 2023
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
215334GAMDSurgical Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 215334 GA Yes

Addresses

Primary practice location

6325 Hospital Pkwy
Johns Creek, GA 30097-5775

Mailing address

3222 Grove Meadows CV
Lawrenceville, GA 30044-3459

Other providers in Johns Creek, GA

All providers in Johns Creek, GA · Surgical Assistant in Georgia

Sources for this page

Verify at the official NPI Registry.