Provider Demographics
NPI:1699923169
Name:NURPEISOV, VIKTORIA (MD)
Entity type:Individual
Prefix:DR
First Name:VIKTORIA
Middle Name:
Last Name:NURPEISOV
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:582 CONCORD RD SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-2616
Mailing Address - Country:US
Mailing Address - Phone:470-956-4000
Mailing Address - Fax:770-319-5703
Practice Address - Street 1:582 CONCORD RD SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-2616
Practice Address - Country:US
Practice Address - Phone:470-956-4000
Practice Address - Fax:770-319-5703
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA64686207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA58-2329008Medicaid