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General NPI Number Information
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NPI Number | 1356900385
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Entity Type | Individual
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Provider Name | SARFRAZ AHMAD MOHAMED MD
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Gender | Male
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Dates
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Enumeration Date | 06/12/2019
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 2400 MOUNT ZION PKWY
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City | JONESBORO
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State | GA
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Zip | 30236-2500
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Country | US
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Telephone | 404-365-0966
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Fax |
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Provider Business Mailing Address
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Address Line | 283 GRANDMAR CHASE
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City | CANTON
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State | GA
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Zip | 30115-6435
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 99366
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 273R00000X
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License Number State | NY
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