Provider Demographics
NPI:1922026525
Name:BUCHANAN, ARIANA DAWN (MD)
Entity Type:Individual
Prefix:
First Name:ARIANA
Middle Name:DAWN
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 PEACHTREE ST. NW
Mailing Address - Street 2:SUITE 720
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-2511
Mailing Address - Country:US
Mailing Address - Phone:404-351-7520
Mailing Address - Fax:404-355-2048
Practice Address - Street 1:150 CLINIC AVENUE
Practice Address - Street 2:SUITE 102
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117
Practice Address - Country:US
Practice Address - Phone:404-351-7520
Practice Address - Fax:404-355-2048
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048323207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA922350658AMedicaid
GA922350658AMedicaid
GA03BDBSKMedicare ID - Type Unspecified