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General NPI Number Information
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NPI Number | 1356667471
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Entity Type | Individual
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Provider Name | MARYAM HOSSEINI M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/14/2010
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 2801 BUFORD HIGHWAY SUITE T-60-A
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City | ATLANTA
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State | GA
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Zip | 30329
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Country | US
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Telephone | 678-653-0329
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Fax |
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Provider Business Mailing Address
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Address Line | 2897 N DRUID HILLS RD NE STE 509
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City | ATLANTA
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State | GA
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Zip | 30329-3924
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Country | US
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Telephone | 678-653-0329
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 71842
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License Number State | GA
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