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NPI Code Detail

MEDICARE: ABANA FARYAL AZARIAH M.D.

MEDICARE: ABANA FARYAL AZARIAH M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2208100000XPhysical Medicine & Rehabilitation PhysicianS2228TX

General Provider Information

NPI Number : 1063822880
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABANA FARYAL AZARIAH M.D.
Provider Business Mailing Address
First Line : 2020 PEACHTREE RD NW
Second Line :
City : ATLANTA
State : GA
Zip : 30309-1465
Country : US
Telephone Number : 404-352-2020
Fax Number :
Provider Business Practice Location Address
First Line : 2020 PEACHTREE RD NW
Second Line :
City : ATLANTA
State : GA
Zip : 30309-1465
Country : US
Telephone Number : 404-352-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2014
Last Update Date : 01/20/2025

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