Basic Information
| Provider Information | |||||||||
| NPI: | 1194715946 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ATEFI | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | AMIR | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ATEFI | ||||||||
| OtherFirstName: | DAWOUD | ||||||||
| OtherMiddleName: | AMIR | ||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1355 PEACHTREE ST NE STE 1600 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303093276 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6782237774 | ||||||||
| FaxNumber: | 6783881759 | ||||||||
| Practice Location | |||||||||
| Address1: | 1340 UPPER HEMBREE RD STE A | ||||||||
| Address2: | |||||||||
| City: | ROSWELL | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30076 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7705690777 | ||||||||
| FaxNumber: | 7705697631 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2005 | ||||||||
| LastUpdateDate: | 09/04/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 19029 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 000201132G | 05 | GA | MEDICAID |