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General NPI Number Information
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NPI Number | 1659587301
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Entity Type | Organization
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Legal Business Name | FAUZIA K. DURRANI M.D., PC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 08/08/2008
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Provider Practice Location Address
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Address Line | 107 WOODROW WILSON DR
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City | VALDOSTA
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State | GA
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Zip | 31602-2539
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Country | US
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Telephone | 229-247-7753
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Fax | 229-247-7849
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Provider Business Mailing Address
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Address Line | 107 WOODROW WILSON DR
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City | VALDOSTA
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State | GA
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Zip | 31602-2539
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Country | US
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Telephone | 229-247-7753
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Fax | 229-247-7849
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Authorized Official
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Title or Position | OWNER
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Name | MS. FAUZIA K DURRANI
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Credential | M.D.
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Telephone | 229-247-7753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 018800
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License Number State | GA
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