Provider Demographics
NPI:1780984658
Name:ARYAIE, AMIR H (MD)
Entity type:Individual
Prefix:DR
First Name:AMIR
Middle Name:H
Last Name:ARYAIE
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 1:1105 UPPER HEMBREE RD STE A
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-0912
Mailing Address - Country:US
Mailing Address - Phone:404-512-6648
Mailing Address - Fax:
Practice Address - Street 1:1105 UPPER HEMBREE RD STE A
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-0912
Practice Address - Country:US
Practice Address - Phone:678-626-0909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA75376208600000X
OH57.018576390200000X
OH35.125225208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program