Provider Demographics
NPI:1023423845
Name:TARIQ, RANA ZOUVEENOOR (MD)
Entity type:Individual
Prefix:MR
First Name:RANA
Middle Name:ZOUVEENOOR
Last Name:TARIQ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RANA
Other - Middle Name:
Other - Last Name:ZOUVEENOOR TARIQ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 742616
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-2616
Mailing Address - Country:US
Mailing Address - Phone:770-219-8420
Mailing Address - Fax:
Practice Address - Street 1:1404 RIVER PL STE 501
Practice Address - Street 2:
Practice Address - City:BRASELTON
Practice Address - State:GA
Practice Address - Zip Code:30517-5600
Practice Address - Country:US
Practice Address - Phone:770-534-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-01
Last Update Date:2024-11-26
Deactivation Date:2015-02-06
Deactivation Code:
Reactivation Date:2015-05-07
Provider Licenses
StateLicense IDTaxonomies
IL125065633207R00000X
GA101722207RC0000X
IN01083033A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine