Individual
MEHRDOD EHTESHAMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1800 10TH AVE, COLUMBUS, GA 31901-1513
(706) 571-1120
(706) 571-1603
Mailing address
PO BOX 1038, COLUMBUS, GA 31902-1038
(706) 571-1120
(706) 571-1603
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
067010
GA
207Q00000X
Family Medicine Physician
Primary
67010
GA
Other
Enumeration date
06/22/2010
Last updated
03/23/2022
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