MEDICARE: DR. FAUZIA K DURRANI MD

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	174400000X	Specialist	018800	GA

General Provider Information

NPI Number	:	1548224413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FAUZIA K DURRANI MD

Provider Business Mailing Address
First Line	:	3308 GREYSTONE WAY
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31605-1096
Country	:	US
Telephone Number	:	229-247-7753
Fax Number	:	229-247-7849

Provider Business Practice Location Address
First Line	:	3308 GREYSTONE WAY
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31605-1096
Country	:	US
Telephone Number	:	229-247-7753
Fax Number	:	229-247-7849

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

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	10/28/2013

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