Organization
BUFORD CARE INC
Active
Other names
Buford Care Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MOHSEN KHODAKARAM MD (OWNER)
(770) 945-4800
Entity
Organization
Contact information
Practice address
2721 BUFORD HIGHWAY NE, BUFORD, GA 30518
(770) 945-4800
(770) 271-8428
Mailing address
2721 BUFORD HIGHWAY NE, BUFORD, GA 30518
(770) 945-4800
(770) 271-8428
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
GA051673
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
699854934A
—
GA
01
—
GRP6216
MEDICARE GROUP
—
Enumeration date
12/06/2007
Last updated
10/23/2020
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