Provider Demographics
NPI:1982064358
Name:YEGANEH, VAHID (M D)
Entity type:Individual
Prefix:
First Name:VAHID
Middle Name:
Last Name:YEGANEH
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 PHARR RD NE STE 525
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-3432
Mailing Address - Country:US
Mailing Address - Phone:404-443-3833
Mailing Address - Fax:404-301-8261
Practice Address - Street 1:550 PHARR RD NE STE 525
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-3432
Practice Address - Country:US
Practice Address - Phone:404-443-3833
Practice Address - Fax:404-301-8261
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA83609207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine