Provider Demographics
NPI:1538144613
Name:AZIZ, ARIF A (MD)
Entity Type:Individual
Prefix:
First Name:ARIF
Middle Name:A
Last Name:AZIZ
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 1:711 CANTON RD NE STE 300
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-8949
Mailing Address - Country:US
Mailing Address - Phone:678-741-5000
Mailing Address - Fax:770-944-4522
Practice Address - Street 1:711 CANTON RD NE
Practice Address - Street 2:SUITE 300
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060
Practice Address - Country:US
Practice Address - Phone:770-429-0031
Practice Address - Fax:678-819-4299
Is Sole Proprietor?:No
Enumeration Date:2005-12-12
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048477207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00885607AMedicaid
GA511I100035Medicare UPIN
GAG27124Medicare UPIN