Healthcare Provider Details

I. General information

NPI: 1821293366
Provider Name (Legal Business Name): HAMID V. TEHRANI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1570 WARSAW RD
ROSWELL GA
30076-1532
US

IV. Provider business mailing address

1570 WARSAW RD
ROSWELL GA
30076-1532
US

V. Phone/Fax

Practice location:
  • Phone: 404-904-0925
  • Fax: 404-506-9663
Mailing address:
  • Phone: 404-410-1001
  • Fax: 404-506-9663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number71029
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101244271
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number244551-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: