Individual
BABAK FAYYAZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
145 EAGLES WALK STE A, STOCKBRIDGE, GA 30281-7340
(770) 914-1808
Mailing address
3333 RIVERWOOD PKWY SE STE 250, ATLANTA, GA 30339-3304
(470) 615-3389
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN254617
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN254617
—
GA
Enumeration date
11/19/2020
Last updated
06/09/2021
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