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General NPI Number Information
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NPI Number | 1003171166
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Entity Type | Individual
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Provider Name | RANA BOTLANI ESFAHANI MD
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Gender | Female
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Dates
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Enumeration Date | 07/05/2012
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Last Update Date | 07/05/2012
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Provider Practice Location Address
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Address Line | 1000 CORPORATE CENTER DR STE 200
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City | MORROW
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State | GA
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Zip | 30260-4180
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Country | US
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Telephone | 770-968-6464
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 CORPORATE CENTER DR STE 200
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City | MORROW
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State | GA
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Zip | 30260-4180
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5746
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License Number State | GA
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