Healthcare Provider Details

I. General information

NPI: 1932549433
Provider Name (Legal Business Name): DARIUSH SHAHSAVARI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2013
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4181 HOSPITAL DR NE STE 202
COVINGTON GA
30014-2541
US

IV. Provider business mailing address

1416 FELDSPAR CT
AUGUSTA GA
30909-0079
US

V. Phone/Fax

Practice location:
  • Phone: 770-385-4291
  • Fax:
Mailing address:
  • Phone: 443-214-4661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD458254
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number89029
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number89029
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: