DR. ROBERT GLEN BASHUK (NPI# 1316940547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316940547 |
| Entity Type | Individual |
| Full Name | DR. ROBERT GLEN BASHUK |
| Credential | M.D. |
| Practice Address |
4460 Austell Rd Austell GA 30106-1844 |
| Mailing Address |
3875 Austell Rd Ste 204 Austell GA 30106-1153 |
| Practice Telephone | 7709414716 |
| Practice Fax Number | 7709413047 |
| Mailing Telephone | 7708191717 |
| Mailing Fax Number | 7708191140 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2010-12-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
026451 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000345639S | 05 | |
| GA | RAILROAD MEDICARE | 130014132 | 01 |
| Street Address |
4460 AUSTELL RD |
| City | AUSTELL |
| State | GA |
| Zip Code | 30106-1844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922646215 | Caroline Digiacomo | Nurse Practitioner | 4460 Austell Rd, Austell, GA 30106-1844 | 2019-12-17 |
| 1841625001 | American Health Imaging of Ga LLC | Clinic/Center | 4460 Austell Rd, Suite 110, Austell, GA 30106-1844 | 2013-09-06 |
| 1942360912 | Northwest Neurology, P.C. | Psychiatry & Neurology | 4460 Austell Rd, Austell, GA 30106-1844 | 2006-12-11 |
| 1164460614 | Sandy Shaw Mcgaffigan | Psychiatry & Neurology | 4460 Austell Rd, Austell, GA 30106-1844 | 2006-06-04 |
| 1659341303 | Saba V Bejanishvili | Psychiatry & Neurology | 4460 Austell Rd, Austell, GA 30106-1844 | 2006-01-25 |
| 1942203179 | Marvin Alan Rachelefsky | Psychiatry & Neurology | 4460 Austell Rd, Austell, GA 30106-1844 | 2005-05-23 |
| 1740283969 | Jeffrey Scott Charpentier | Psychiatry & Neurology | 4460 Austell Rd, Austell, GA 30106-1844 | 2005-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073126231 | Courtney Lashune Dorsett | Nurse Practitioner | 1005 Cureton Drive, Austell, Austell, GA 30106 | 2020-08-27 |
| 1184240491 | Brian H Eves | Dietitian, Registered | 3972 Brantley Drive, Austell, GA 30106 | 2020-06-23 |
| 1669014486 | Jesse Mccoy | Registered Nurse | 3950 Austell Rd., Austell, GA 30106 | 2019-10-14 |
| 1427522820 | Envision Optics LLC | Optometrist | 1680 E West Connector, Austell, GA 30106 | 2019-01-18 |
| 1972042380 | Thomas Dental Group | Clinic/Center | 1133 East West Connector, Suite 120, Austell, GA 30106 | 2017-02-17 |
| 1245779792 | Colton Dental Group | Clinic/Center | 2495 East-west Connector, Ste 60, Austell, GA 30106 | 2017-02-16 |
| 1144691684 | Georgia Dental Professionals, PC | Dentist | 780 East West Connector Sw, Suite 108, Austell, GA 30106 | 2015-10-09 |
| 1285013714 | Ikeade Bello Alamu | Nurse Practitioner | 2870 Betula Drive, Austell, GA 30106 | 2015-05-29 |
| 1376922211 | Jessica Williams | Obstetrics & Gynecology | 1700 Hospital South Dr Ste 500, Austell, GA 30106 | 2015-05-26 |
| 1558799593 | Tonya Renee Baldwin | Speech-Language Pathologist | 4229 Brass Trl., Austell, GA 30106 | 2013-10-30 |
| Find all providers in zip 30106 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285880443 | Sital Vijendra Patel | Psychiatry & Neurology | 3875 Austell Rd, Suite 204, Austell, GA 30106-1103 | 2008-08-07 |
| 1942360912 | Northwest Neurology, P.C. | Psychiatry & Neurology | 4460 Austell Rd, Austell, GA 30106-1844 | 2006-12-11 |
| 1164460614 | Sandy Shaw Mcgaffigan | Psychiatry & Neurology | 4460 Austell Rd, Austell, GA 30106-1844 | 2006-06-04 |
| 1659341303 | Saba V Bejanishvili | Psychiatry & Neurology | 4460 Austell Rd, Austell, GA 30106-1844 | 2006-01-25 |
| 1942203179 | Marvin Alan Rachelefsky | Psychiatry & Neurology | 4460 Austell Rd, Austell, GA 30106-1844 | 2005-05-23 |
| 1740283969 | Jeffrey Scott Charpentier | Psychiatry & Neurology | 4460 Austell Rd, Austell, GA 30106-1844 | 2005-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013544899 | Southern Neurology, Physical Medicine & Rehabilitation, LLC | Psychiatry & Neurology | 4913 Lanes Pond Rd, Valdosta, GA 31601-1537 | 2020-03-24 |
| 1912474537 | Atlanta Neuromonitoring, LLC | Psychiatry & Neurology | 922 Highway 81 East # 242, Mcdonough, GA 30252 | 2018-11-01 |
| 1366925497 | David Wayne Richardson | Psychiatry & Neurology | 400 Rock Springs Road Ne, Atlanta, GA 30324 | 2018-09-14 |
| 1407349103 | Ahmed Babiker | Psychiatry & Neurology | 1130 15th St, Augusta, GA 30912-0004 | 2018-06-07 |
| 1811342561 | The Migraine and Spine Clinic of Valdosta LLC | Psychiatry & Neurology | 3315 N Valdosta Rd, Suite A, Valdosta, GA 31602-1107 | 2016-05-02 |
| 1164882635 | Lafayette Neurology, PC | Psychiatry & Neurology | 1075 Lafayette Parkway, Suite 210, Lagrange, GA 30241-3584 | 2016-02-26 |
| 1144601048 | Catherine Lockhart | Psychiatry & Neurology | 2470 Daniels Bridge Rd Ste 261, Athens, GA 30606-6188 | 2015-06-16 |
| 1609266634 | Bruce Gillett | Psychiatry & Neurology | 948 Greymont Cir Nw, Marietta, GA 30064-1328 | 2015-01-29 |
| 1245620244 | Darla R Totten Md | Psychiatry & Neurology | 3780 Northside Dr, 197, Macon, GA 31210-2431 | 2015-01-28 |
| 1033516356 | Neuro Proread Solutions | Psychiatry & Neurology | 2378 Riderwood Court, Marietta, GA 30062-4689 | 2014-12-02 |
| Find all providers with the same taxonomy | ||||
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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.