Individual
DARIUSH HEIDARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4750 WATERS AVE, SUITE 452, SAVANNAH, GA 31404-6200
(912) 354-7188
(912) 354-5208
Mailing address
4750 WATERS AVE, SUITE 452, SAVANNAH, GA 31404-6200
(912) 354-7188
(912) 354-5208
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
018668
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000133042D
—
GA
05
—
146170
—
SC
01
—
582162071066
CHAMPUS
—
01
—
967351
BLUE CROSS BLUE SHIELD
GA
01
—
P00279274
RAILROAD MEDICARE
—
Enumeration date
06/08/2006
Last updated
02/07/2011
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