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General NPI Number Information
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NPI Number | 1962551697
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Entity Type | Organization
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Legal Business Name | GORDON AZAR INTERNAL MEDICINE AND CARDIOLOGY
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 960 JOHNSON FERRY RD NE SUITE 235
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City | ATLANTA
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State | GA
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Zip | 30342-1631
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Country | US
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Telephone | 404-256-9572
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Fax |
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Provider Business Mailing Address
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Address Line | 960 JOHNSON FERRY RD NE SUITE 235
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City | ATLANTA
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State | GA
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Zip | 30342-1631
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Country | US
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Telephone | 404-256-9572
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GORDON AZAR
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Credential | M.D.
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Telephone | 404-856-9572
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State | GA
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