Healthcare Provider Details

I. General information

NPI: 1326160078
Provider Name (Legal Business Name): ARMIN VATANI OSKOUEI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 01/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5730 GLENRIDGE DR SUITE 230
ATLANTA GA
30328-6141
US

IV. Provider business mailing address

11770 HAYNES BRIDGE RD STE 205-354
ALPHARETTA GA
30009-1966
US

V. Phone/Fax

Practice location:
  • Phone: 678-752-7246
  • Fax: 678-530-1042
Mailing address:
  • Phone: 678-752-7246
  • Fax: 678-530-1042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number63271
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: