Provider Demographics
NPI:1932696085
Name:GHAFARIAN, ROMINA (MD)
Entity Type:Individual
Prefix:
First Name:ROMINA
Middle Name:
Last Name:GHAFARIAN
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 1:2500 HOSPITAL BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-4990
Mailing Address - Country:US
Mailing Address - Phone:770-442-1111
Mailing Address - Fax:
Practice Address - Street 1:2500 HOSPITAL BLVD STE 250
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4990
Practice Address - Country:US
Practice Address - Phone:770-442-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-15
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA89574207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine