Dr IBREZ R BANDUKWALA is a male medical professional, specializing in Internal Medicine. He graduated in 1997 from University Of North Carolina At Chapel Hill School Of Medicine.
LAUREATE MEDICAL GROUP AT NORTHSIDE, LLC
7823 SPIVEY STATION BLVD
SUITE 310
JONESBORO
GA
302362886
Tel: 7709961122
| Npi | 1720030109 |
| Pac Id | 4981887080 |
| Professional Enrollment Id | I20110505000161 |
| Last Name | BANDUKWALA |
| First Name | IBREZ |
| Middle Name | R |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL SCHOOL OF MEDICINE |
| Graduation Year | 1997 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialty 1 | |
| Secondary Specialty 2 | |
| Secondary Specialty 3 | |
| Secondary Specialty 4 | |
| All Secondary Specialties | |
| Organization Legal Name | LAUREATE MEDICAL GROUP AT NORTHSIDE, LLC |
| Group Practice Pac Id | 2668458530 |
| Number Of Group Practice Members | 56 |
| Line 1 Street Address | 7823 SPIVEY STATION BLVD |
| Line 2 Street Address | SUITE 310 |
| Marker Of Address Line 2 Suppression | |
| City | JONESBORO |
| State | GA |
| Zip Code | 302362886 |
| Phone Number | 7709961122 |
| Hospital Affiliation Ccn 1 | 110161 |
| Hospital Affiliation Lbn 1 | NORTHSIDE HOSPITAL |
| Hospital Affiliation Ccn 2 | 110082 |
| Hospital Affiliation Lbn 2 | SAINT JOSEPH'S HOSPITAL OF ATLANTA, INC |
| Hospital Affiliation Ccn 3 | 110008 |
| Hospital Affiliation Lbn 3 | NORTHSIDE HOSPITAL CHEROKEE |
| Hospital Affiliation Ccn 4 | 110083 |
| Hospital Affiliation Lbn 4 | PIEDMONT HOSPITAL |
| Hospital Affiliation Ccn 5 | 110005 |
| Hospital Affiliation Lbn 5 | NORTHSIDE HOSPITAL FORSYTH |
| Professional Accepts Medicare Assignment | Y |
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