Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 66974 | GA |
N | 207Q00000X | Family Doctor | OS9536 | FL |
NPI | 1003828021 |
---|---|
Provider Name | Chhavi V Noohani |
First Address | Woodstock, GA 30189-1600 |
Second Address | Woodstock, GA 30189-1600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2006 |
Last Update Date | 26/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
274065600 | (05) | FL |
30712 | BCBS (01) | FL |
H98468 | (02) | |
P00387710 | RAILROAD MEDICARE (01) |