Provider Demographics
NPI:1639135205
Name:TAHIR, HINDIA (MD)
Entity type:Individual
Prefix:DR
First Name:HINDIA
Middle Name:
Last Name:TAHIR
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 1:2727 PACES FERRY RD SE STE 1-100
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-6150
Mailing Address - Country:US
Mailing Address - Phone:706-475-5076
Mailing Address - Fax:706-475-6676
Practice Address - Street 1:1199 PRINCE AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606
Practice Address - Country:US
Practice Address - Phone:706-475-5076
Practice Address - Fax:706-475-6676
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA057501174400000X, 207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA555189352AMedicaid
GAI51262Medicare UPIN
GA39BDCMDMedicare ID - Type Unspecified