Healthcare Provider Details

I. General information

NPI: 1073425641
Provider Name (Legal Business Name): MERIDIAN ENDOCRINOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10475 MEDLOCK BRIDGE RD STE 820
JOHNS CREEK GA
30097-4437
US

IV. Provider business mailing address

10475 MEDLOCK BRIDGE RD STE 820
JOHNS CREEK GA
30097-4437
US

V. Phone/Fax

Practice location:
  • Phone: 678-224-8686
  • Fax: 678-224-8879
Mailing address:
  • Phone: 713-412-6769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANBAR KHIYANI
Title or Position: MD
Credential: MD
Phone: 713-412-6769