MEDICARE: NOJAN VALADI 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	2084V0102X	Vascular Neurology Physician	62172	GA
2	208M00000X	Hospitalist Physician	62172	GA
3	2084N0400X	Neurology Physician	62172	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	202I139562	OTHER	GA	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417171737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOJAN VALADI M.D.

Provider Business Mailing Address
First Line	:	2570 VILLAGE PROFESSIONAL DR
Second Line	:
City	:	OPELIKA
State	:	AL
Zip	:	36801-2380
Country	:	US
Telephone Number	:	334-203-1917
Fax Number	:

Provider Business Practice Location Address
First Line	:	2570 VILLAGE PROFESSIONAL DR
Second Line	:
City	:	OPELIKA
State	:	AL
Zip	:	36801-2380
Country	:	US
Telephone Number	:	334-203-1917
Fax Number	:

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

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	05/03/2021

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Directions to “ NOJAN VALADI M.D.” Practice Location

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