Individual
SHAHRAM BOZORGNIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1120 15TH ST, BA 3300, AUGUSTA, GA 30912-0004
(706) 721-4666
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 828-8403
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
063296
GA
207XX0801X
Orthopaedic Trauma Physician
63296
GA
Other
Enumeration date
05/07/2007
Last updated
05/29/2019
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