Provider Demographics
NPI:1518098409
Name:SVED, ISAAC (MD)
Entity Type:Individual
Prefix:
First Name:ISAAC
Middle Name:
Last Name:SVED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3331 HAMILTON MILL RD
Mailing Address - Street 2:SUITE 1102
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-4096
Mailing Address - Country:US
Mailing Address - Phone:678-889-2220
Mailing Address - Fax:678-889-2722
Practice Address - Street 1:3331 HAMILTON MILL RD
Practice Address - Street 2:SUITE 1102
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-4096
Practice Address - Country:US
Practice Address - Phone:678-889-2220
Practice Address - Fax:678-889-2722
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA38981207Q00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F91989Medicare UPIN