Provider Demographics
NPI:1083790646
Name:PARHAM, SAEIDEH (DC)
Entity Type:Individual
Prefix:MRS
First Name:SAEIDEH
Middle Name:
Last Name:PARHAM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MRS
Other - First Name:SAEIDEH
Other - Middle Name:MORTAZAVI
Other - Last Name:ZANJANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:770 OLD ROSWELL PL
Mailing Address - Street 2:UNIT H-400
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-1670
Mailing Address - Country:US
Mailing Address - Phone:678-887-4207
Mailing Address - Fax:678-205-5132
Practice Address - Street 1:4063 CLOISTER DR
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-8005
Practice Address - Country:US
Practice Address - Phone:678-887-4207
Practice Address - Fax:678-205-5132
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007724111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA007724OtherCHIROPRACTIC LISC #
GA007724OtherCHIROPRACTIC LISC #
GAV08422Medicare UPIN