Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 7169 | GA |
Y | 207YS0123X | Facial Plastic Surgeon | 84724 | GA |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 37848 | AL |
NPI | 1750709770 |
---|---|
Provider Name | Paul Pedram Daraei |
First Address | Dallas, TX 75373-4315 |
Second Address | Atlanta, GA 30328-4403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2014 |
Last Update Date | 23/07/2020 |