Organization
ADVANCED ALLERGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAZIAR REZVANI M.D. (OWNER)
(404) 983-2034
Entity
Organization
Contact information
Practice address
5512 GLENRIDGE DR NE, UNIT A, ATLANTA, GA 30342-7213
(404) 983-2034
Mailing address
5512 GLENRIDGE DR NE, UNIT A, ATLANTA, GA 30342-7213
(404) 983-2034
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
053937
GA
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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