Basic Information
| Provider Information | |||||||||
| NPI: | 1235339227 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EMORY HEALTHCARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1364 CLIFTON RD NE | ||||||||
| Address2: | HOSPITAL MEDICINE BOX M7 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303221059 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4046867869 | ||||||||
| FaxNumber: | 4047785495 | ||||||||
| Practice Location | |||||||||
| Address1: | 1364 CLIFTON RD NE | ||||||||
| Address2: | HOSPITAL MEDICINE BOX M7 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303221064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4046867869 | ||||||||
| FaxNumber: | 4047785495 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2007 | ||||||||
| LastUpdateDate: | 04/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | YAZDANPANAH | ||||||||
| AuthorizedOfficialFirstName: | WAHID | ||||||||
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| AuthorizedOfficialTitleorPosition: | HOSPITALIST | ||||||||
| AuthorizedOfficialTelephone: | 4046867869 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 59794 | GA | Y | Hospitals | General Acute Care Hospital |
No ID Information.