Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 0101243233 | VA |
N | 208000000X | Pediatrician | 062235 | GA |
Y | 2080P0204X | Pediatric Emergency Doctor | 062235 | GA |
NPI | 1295908705 |
---|---|
Provider Name | Dr. Shervin A Kharazmi |
First Address | Atlanta, GA 30342-1605 |
Second Address | Atlanta, GA 30342-1605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2008 |
Last Update Date | 03/12/2013 |