Healthcare Provider Details

I. General information

NPI: 1609976166
Provider Name (Legal Business Name): BERNARD B KAHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 PIEDMONT RD BLDG 7, STE 407
ATLANTA GA
30305
US

IV. Provider business mailing address

3525 PIEDMONT RD BLDG 7, STE 407
ATLANTA GA
30305
US

V. Phone/Fax

Practice location:
  • Phone: 404-237-3987
  • Fax: 404-237-3707
Mailing address:
  • Phone: 404-237-3987
  • Fax: 404-237-3707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number029896
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number029896
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: