Provider Demographics
NPI:1891242566
Name:NASAJPOUR, HABIB DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:HABIB
Middle Name:DAVID
Last Name:NASAJPOUR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 STUART CASTLE WAY SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-5227
Mailing Address - Country:US
Mailing Address - Phone:770-940-3631
Mailing Address - Fax:
Practice Address - Street 1:104 STUART CASTLE WAY SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-5227
Practice Address - Country:US
Practice Address - Phone:770-940-3631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009764111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner