Healthcare Provider Details

I. General information

NPI: 1174790703
Provider Name (Legal Business Name): ABARMARD MAZIAR ZAFARI M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2008
Last Update Date: 05/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 CLAIRMONT RD ROOM 169
DECATUR GA
30033-4004
US

IV. Provider business mailing address

1639 CLAIRMONT ROAD MAIL CODE 111B ROOM 169
DECATUR GA
30033
US

V. Phone/Fax

Practice location:
  • Phone: 404-327-4019
  • Fax: 404-329-2211
Mailing address:
  • Phone: 404-327-4019
  • Fax: 404-329-2211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number039018
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: