Individual
OMID MIDANAKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2801 N DECATUR RD, DECATUR, GA 30033-5949
(404) 296-5055
Mailing address
810 WHISPERWOOD TRL, ACWORTH, GA 30102-7586
(404) 704-2813
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8538
GA
Other
Enumeration date
08/30/2017
Last updated
07/30/2025
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