Individual
RAOOF KAZEMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAAA
Contact information
Practice address
6649 LAKE DR, MORROW, GA 30260-2354
(770) 968-9978
(770) 968-9975
Mailing address
PO BOX 278, JONESBORO, GA 30237-0278
(770) 968-9978
(770) 968-9975
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
002839
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002839
GA PA LIC
GA
01
—
702
NCCAA
GA
Enumeration date
10/03/2006
Last updated
07/08/2007
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