Individual
HASSAN S MOSTAFAVIPOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD.
Contact information
Practice address
1777 MONTREAL CIR, TUCKER, GA 30084-6802
(770) 621-7422
(770) 621-7530
Mailing address
1777 MONTREAL CIR, TUCKER, GA 30084-6802
(770) 621-7422
(770) 621-7530
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
048921
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048921
MEDICAL LICENSE
GA
Enumeration date
12/14/2007
Last updated
12/14/2007
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