Individual
NIZAR HARIRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1404 RIVER PL STE 201, BRASELTON, GA 30517-5600
(770) 219-4000
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
(757) 224-2198
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101271037
VA
208600000X
Surgery Physician
35131760
OH
208600000X
Surgery Physician
4601500938
MI
2086S0129X
Vascular Surgery Physician
0101271037
VA
2086S0129X
Vascular Surgery Physician
Primary
97125
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
97125
GEORGIA COMPOSITE MEDICAL BOARD
GA
Enumeration date
06/15/2012
Last updated
10/02/2023
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