Provider Demographics
NPI:1023067824
Name:SABERI, ASIF A (MD)
Entity type:Individual
Prefix:
First Name:ASIF
Middle Name:A
Last Name:SABERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 WHITCHER ST NE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1155
Mailing Address - Country:US
Mailing Address - Phone:770-422-1372
Mailing Address - Fax:770-423-9651
Practice Address - Street 1:55 WHITCHER ST NE
Practice Address - Street 2:SUITE 160
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1155
Practice Address - Country:US
Practice Address - Phone:770-422-1372
Practice Address - Fax:770-423-9651
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA054120207RP1001X
GA54120207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00646902OtherMEDICARE RAIL ROAD
GA0300884350CMedicaid
GA511I290042Medicare PIN
GAP00646902OtherMEDICARE RAIL ROAD