Individual
FARIS ANTHONY MIRZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST # BP4109, AUGUSTA, GA 30912-0004
(706) 721-6100
Mailing address
339 RAILROAD AVE # 1-239, NORTH AUGUSTA, SC 29841-3987
(678) 462-9150
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
12833
GA
Other
Enumeration date
06/07/2021
Last updated
06/07/2021
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