Healthcare Provider Details

I. General information

NPI: 1215645924
Provider Name (Legal Business Name): ALIREZA ARABNIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2022
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2275 MARIETTA BLVD NW STE 450
ATLANTA GA
30318-2004
US

IV. Provider business mailing address

73 PRESTIGE LN STE 103
DAWSONVILLE GA
30534-6370
US

V. Phone/Fax

Practice location:
  • Phone: 404-367-4400
  • Fax:
Mailing address:
  • Phone: 706-429-0033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number101614
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: