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Individual

DR. HASAN KHOSRAVI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1519 JOHNSON FERRY RD STE 175, MARIETTA, GA 30062-6411
(770) 814-8222
(678) 205-5111
Mailing address
PO BOX 23329, NEW YORK, NY 10087-3329

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
036.155306
IL
207N00000X
Dermatology Physician
Primary
101902
GA

Other

Enumeration date
06/21/2017
Last updated
04/10/2026
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