MEDICARE: DR. HOWARD MAZIAR 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	2084P0800X	Psychiatry Physician	015488	GA

General Provider Information

NPI Number	:	1669536108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD MAZIAR M.D.

Provider Business Mailing Address
First Line	:	3400 PEACHTREE RD NE
Second Line	:	SUITE 1041
City	:	ATLANTA
State	:	GA
Zip	:	30326-1170
Country	:	US
Telephone Number	:	404-233-4261
Fax Number	:	404-266-1830

Provider Business Practice Location Address
First Line	:	3400 PEACHTREE RD NE
Second Line	:	SUITE 1041
City	:	ATLANTA
State	:	GA
Zip	:	30326-1170
Country	:	US
Telephone Number	:	404-233-4261
Fax Number	:	404-266-1830

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

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	07/08/2007

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