Organization
DR.M.NIKNAFS PODIATRIST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOSTAFA NIKNAFS (PRESIDENT)
(706) 548-2544
Entity
Organization
Contact information
Practice address
1010 PRINCE AVE, SUITE 180, ATHENS, GA 30606-5805
(706) 548-2544
Mailing address
1010 PRINCE AVE STE 180, ATHENS, GA 30606-5815
(706) 548-2544
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00299637B
—
GA
Enumeration date
03/17/2008
Last updated
03/19/2008
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