Provider Demographics
NPI:1578564837
Name:SEIRAFI, PETER ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:ALI
Last Name:SEIRAFI
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:PO BOX 1038
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31902-1038
Mailing Address - Country:US
Mailing Address - Phone:706-320-8660
Mailing Address - Fax:706-320-8770
Practice Address - Street 1:2000 10TH AVE
Practice Address - Street 2:SUITE 225
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-3700
Practice Address - Country:US
Practice Address - Phone:706-320-8750
Practice Address - Fax:706-320-8770
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80733208G00000X
GA069913208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPRO6612OtherQUALITY HEALTH PLAN
AL7435144OtherAETNA PROVIDER PIN #
FL162138OtherWELLCARE
FL2610659OtherCIGNA
FL35676OtherBCBS FL
613325100OtherFEDERAL BLACK LUNG
FL1865828OtherAETNA FL
613325100OtherFEDERAL BLACK LUNG
FL35676OtherBCBS FL
H23723Medicare UPIN