Provider Demographics
NPI:1407892326
Name:POHLEL, FERDOS KHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:FERDOS
Middle Name:KHAN
Last Name:POHLEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 OGLETHORPE AVE
Mailing Address - Street 2:SUITE 600A
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2179
Mailing Address - Country:US
Mailing Address - Phone:706-475-4933
Mailing Address - Fax:706-208-8259
Practice Address - Street 1:1199 PRINCE AVE
Practice Address - Street 2:MSB 2ND FLOOR
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2797
Practice Address - Country:US
Practice Address - Phone:706-475-1700
Practice Address - Fax:706-475-1790
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA053515207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA552653279HMedicaid
GA552653279FMedicaid
GA552653279GMedicaid
GA552653279IMedicaid
GA552653279CMedicaid
GA552653279DMedicaid
GA552653279EMedicaid
GA552653279JMedicaid
GA202I064716Medicare PIN
GA552653279FMedicaid