MEDICARE: DR. EVELYN AKINSANMI DARIUS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program		CA
2	207Q00000X	Family Medicine Physician	80155	GA

General Provider Information

NPI Number	:	1124219696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EVELYN AKINSANMI DARIUS M.D.

Provider Business Mailing Address
First Line	:	1612 OLD HUNTERS TRCE
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-6170
Country	:	US
Telephone Number	:	423-829-1089
Fax Number	:

Provider Business Practice Location Address
First Line	:	3640 TRAMORE POINTE PKWY
Second Line	:
City	:	AUSTELL
State	:	GA
Zip	:	30106-6825
Country	:	US
Telephone Number	:	404-365-0966
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2007
Last Update Date	:	10/18/2018

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