Individual
ASHKAN YAZDANPANAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
677 CHURCH ST NE, MARIETTA, GA 30060-1101
(770) 794-0477
(770) 794-3108
Mailing address
531 ROSELANE STREET NW, SUITE 830, MARIETTA, GA 30060
(770) 794-0477
(770) 794-3108
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
055464
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
055464
GA
207LP3000X
Pediatric Anesthesiology Physician
055464
GA
208VP0000X
Pain Medicine Physician
055464
GA
208VP0014X
Interventional Pain Medicine Physician
055464
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
444004410A
—
GA
05
—
444004410B
—
GA
05
—
444004410C
—
GA
05
—
444004410D
—
GA
05
—
444004410E
—
GA
05
—
444004410F
—
GA
Enumeration date
05/24/2006
Last updated
08/29/2019
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