Healthcare Provider Details

I. General information

NPI: 1619255882
Provider Name (Legal Business Name): RASIK PARMAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2011
Last Update Date: 10/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2518 JIMMY LEE SMITH PKWY
HIRAM GA
30141-2068
US

IV. Provider business mailing address

2518 JIMMY LEE SMITH PKWY
HIRAM GA
30141-2068
US

V. Phone/Fax

Practice location:
  • Phone: 770-732-4022
  • Fax:
Mailing address:
  • Phone: 770-732-4022
  • Fax: 770-732-4023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number069417
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.097586
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: