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Organization
SDRASSISTING, LLC
Active
Organization
SDRASSISTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SPENSOR RAYETPARVAR (CSFA)
(404) 683-7123
Entity
Organization
Contact information
Practice address
1265 HIGHWAY 54 W STE 103, FAYETTEVILLE, GA 30214-4537
(404) 683-7123
(470) 514-5561
Mailing address
2640 SUNCREST DR, BUFORD, GA 30519-5184
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
NULL
246ZC0007X
Surgical Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
03/03/2025
Last updated
05/18/2026
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