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Individual

DR. TAPAN K. DAFTARI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2041 MESA VALLEY WAY, SUITE 100, AUSTELL, GA 30106-8157
(770) 944-1100
(770) 944-6469
Mailing address
2041 MESA VALLEY WAY, SUITE 100, AUSTELL, GA 30106-8157
(770) 944-1100
(770) 944-6469

Taxonomy

Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
032541
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000660118G
GA
05
000660118H
GA
05
000660118I
GA
05
000660118K
GA
Enumeration date
09/29/2005
Last updated
02/05/2009
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