Individual
DR. PUYA DAVOODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1296 SIMS ST STE B, GAINESVILLE, GA 30501-3835
(770) 534-1856
(770) 531-0355
Mailing address
1296 SIMS ST STE B, GAINESVILLE, GA 30501-3873
(770) 534-1856
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
062833
GA
208600000X
Surgery Physician
LL25628
SC
2086S0122X
Plastic and Reconstructive Surgery Physician
062833
GA
2086S0122X
Plastic and Reconstructive Surgery Physician
ME111956
FL
2086S0122X
Plastic and Reconstructive Surgery Physician
TRN13669
FL
208D00000X
General Practice Physician
062833
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006099600
—
FL
Enumeration date
10/17/2006
Last updated
10/07/2020
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