Provider Demographics
NPI:1558929448
Name:PEACE OF MIND PSYCHIATRIC SERVICES PC
Entity Type:Organization
Organization Name:PEACE OF MIND PSYCHIATRIC SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIANS
Authorized Official - Prefix:DR
Authorized Official - First Name:RANJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AVASTHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-870-4290
Mailing Address - Street 1:3210 OAKDALE RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30354-1038
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3338 DOGWOOD DR
Practice Address - Street 2:
Practice Address - City:HAPEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30354-1440
Practice Address - Country:US
Practice Address - Phone:678-870-4290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1801068507OtherINDIVIDUAL NPI