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Individual

BOB B BAGHERI

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
204 CANTON RD, CUMMING, GA 30040-2304
(770) 886-5437
(770) 886-5437
Mailing address
11565 MOUNTAIN LAUREL DR, ROSWELL, GA 30075-1333
(770) 886-5437
(770) 886-9717

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
040865
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00682107D
GA
Enumeration date
03/16/2006
Last updated
07/08/2007
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