Provider Demographics
NPI:1659469674
Name:SAADAT, MEHRDAD E (OD)
Entity Type:Individual
Prefix:
First Name:MEHRDAD
Middle Name:E
Last Name:SAADAT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 CRESTMARK DR STE 101
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-2646
Mailing Address - Country:US
Mailing Address - Phone:770-948-0036
Mailing Address - Fax:770-948-0090
Practice Address - Street 1:880 CRESTMARK DR STE 101
Practice Address - Street 2:
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-2646
Practice Address - Country:US
Practice Address - Phone:770-948-0036
Practice Address - Fax:770-948-0090
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002245152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist