Provider Demographics
NPI:1497934129
Name:NAYYAR, CHARISHMA (PA)
Entity Type:Individual
Prefix:MS
First Name:CHARISHMA
Middle Name:
Last Name:NAYYAR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:975 JOHNSON FERRY RD NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1618
Mailing Address - Country:US
Mailing Address - Phone:404-256-1311
Mailing Address - Fax:404-705-2774
Practice Address - Street 1:975 JOHNSON FERRY RD NE
Practice Address - Street 2:SUITE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1618
Practice Address - Country:US
Practice Address - Phone:404-256-1311
Practice Address - Fax:404-705-2774
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY012074363AS0400X
GA6654363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical