Provider Demographics
NPI:1407053044
Name:ZAFAR, MOZHGAN (MD)
Entity Type:Individual
Prefix:
First Name:MOZHGAN
Middle Name:
Last Name:ZAFAR
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 1:1800 TREE LN STE 320
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-6794
Mailing Address - Country:US
Mailing Address - Phone:770-284-3043
Mailing Address - Fax:888-814-0930
Practice Address - Street 1:1800 TREE LN STE 320
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6794
Practice Address - Country:US
Practice Address - Phone:770-284-3043
Practice Address - Fax:888-814-0930
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA36947207R00000X
GA66844207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP00445301OtherRR MEDICARE
IAI21110Medicare PIN