Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | CHIR009764 | GA |
NPI | 1891242566 |
---|---|
Provider Name | Dr. Habib David Nasajpour |
First Address | Smyrna, GA 30082-5227 |
Second Address | Smyrna, GA 30082-5227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2016 |
Last Update Date | 09/09/2016 |