Provider Demographics
NPI:1760488530
Name:LARI, STEVEN JUD (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JUD
Last Name:LARI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 GLENLAKE PKWY NE
Mailing Address - Street 2:STE 1045
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3448
Mailing Address - Country:US
Mailing Address - Phone:770-399-9299
Mailing Address - Fax:770-399-5499
Practice Address - Street 1:1 GLENLAKE PKWY NE
Practice Address - Street 2:STE 1045
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3448
Practice Address - Country:US
Practice Address - Phone:770-399-9299
Practice Address - Fax:770-399-5499
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-24
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
GA0281822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD40408Medicare UPIN