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General NPI Number Information
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NPI Number | 1295272763
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Entity Type | Individual
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Provider Name | MEHTAAB DOBANI NP-C
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Gender | Female
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Dates
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Enumeration Date | 01/23/2017
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Last Update Date | 09/23/2020
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Provider Practice Location Address
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Address Line | 3925 JOHNS CREEK CT STE A
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City | SUWANEE
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State | GA
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Zip | 30024-6618
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Country | US
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Telephone | 770-373-7973
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Fax |
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Provider Business Mailing Address
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Address Line | 2760 WOODBINE HILL WAY
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City | NORCROSS
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State | GA
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Zip | 30071-2844
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Country | US
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Telephone | 404-786-2004
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN231544
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License Number State | GA
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