Provider Demographics
NPI:1457372799
Name:VASHI, DIPAK V (MD)
Entity Type:Individual
Prefix:DR
First Name:DIPAK
Middle Name:V
Last Name:VASHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:875 JOHNSON FERRY RD NE STE 200
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1418
Mailing Address - Country:US
Mailing Address - Phone:404-778-6100
Mailing Address - Fax:404-778-6160
Practice Address - Street 1:875 JOHNSON FERRY RD NE STE 200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1418
Practice Address - Country:US
Practice Address - Phone:404-778-6100
Practice Address - Fax:404-778-6160
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA043802207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF07080Medicare UPIN