Healthcare Provider Details

I. General information

NPI: 1497172647
Provider Name (Legal Business Name): SAMAN VOJDANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2014
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 HAMMOND DR STE 400
ATLANTA GA
30328-8617
US

IV. Provider business mailing address

1150 HAMMOND DR STE 400
ATLANTA GA
30328-8617
US

V. Phone/Fax

Practice location:
  • Phone: 770-292-6500
  • Fax: 770-292-6535
Mailing address:
  • Phone: 770-292-6500
  • Fax: 770-292-6535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number85724
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: