Individual
SEPEHR PANAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
790 CHURCH ST NE, STE 400, MARIETTA, GA 30060-7282
(770) 952-8899
(678) 581-3680
Mailing address
PO BOX 3157, INDIANAPOLIS, IN 46206-3157
(855) 871-1526
(855) 277-8543
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
053303
GA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
053303
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400570419D
—
GA
Enumeration date
03/07/2006
Last updated
11/20/2023
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