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Individual

DR. MIRZA A KAJANI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
226 E COLLEGE ST, SUITE B, GRIFFIN, GA 30224-4348
(678) 987-1490
(678) 987-1491
Mailing address
226 E COLLEGE ST, SUITE B, GRIFFIN, GA 30224-4348
(678) 987-1490
(678) 987-1491

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
31955
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000403147A
GA
01
102I100129
PTAN
GA
01
202I100956
PTAN
GA
01
300052394
TAX I.D. FOR OTHER INSURA
GA
Enumeration date
03/04/2007
Last updated
03/15/2016
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