Healthcare Provider Details

I. General information

NPI: 1639135205
Provider Name (Legal Business Name): HINDIA TAHIR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 06/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1199 PRINCE AVE
ATHENS GA
30606
US

IV. Provider business mailing address

2727 PACES FERRY RD SE STE 1-100
ATLANTA GA
30339-6150
US

V. Phone/Fax

Practice location:
  • Phone: 706-475-5076
  • Fax: 706-475-6676
Mailing address:
  • Phone: 706-475-5076
  • Fax: 706-475-6676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number057501
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number057501
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number057501
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: