Healthcare Provider Details

I. General information

NPI: 1215399068
Provider Name (Legal Business Name): ERIC ADJEI AFARI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 04/10/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1199 PRINCE AVE
ATHENS GA
30606-2797
US

IV. Provider business mailing address

1199 PRINCE AVE
ATHENS GA
30606-2797
US

V. Phone/Fax

Practice location:
  • Phone: 706-475-7869
  • Fax: 706-475-6676
Mailing address:
  • Phone: 706-475-7869
  • Fax: 706-475-6676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number83865
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberCP209660
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number083865
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: