Individual
GOLNAZ FAKOUR BAYAT SHIRAZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4742
(662) 772-4696
Mailing address
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4742
(901) 301-3570
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/25/2023
Last updated
08/15/2023
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