MEDICARE: DR. MARIELLE ARRIEH JOHARY 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
1	2085R0202X	Diagnostic Radiology Physician	043857	GA
2	208D00000X	General Practice Physician	43857	GA

General Provider Information

NPI Number	:	1134330749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIELLE ARRIEH JOHARY M.D.

Provider Business Mailing Address
First Line	:	780 ARAN DR
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30076-5129
Country	:	US
Telephone Number	:	770-645-5044
Fax Number	:

Provider Business Practice Location Address
First Line	:	1320 CENTER DR
Second Line	:	SUITE 100
City	:	DUNWOODY
State	:	GA
Zip	:	30338-4130
Country	:	US
Telephone Number	:	770-730-8908
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	08/13/2015

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