Individual
DR. KEVIN SHAHBAZIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1120 15TH ST # BI5070, AUGUSTA, GA 30912-0004
(706) 721-2423
Mailing address
1120 15TH ST # BA1404, AUGUSTA, GA 30912-0004
(813) 598-5501
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
10802
GA
2085R0202X
Diagnostic Radiology Physician
10802
GA
2085R0202X
Diagnostic Radiology Physician
Primary
98888
GA
Other
Enumeration date
04/13/2019
Last updated
02/28/2024
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