Provider Demographics
NPI:1841634045
Name:KASHLAN, SAMY RAFIK (MD)
Entity type:Individual
Prefix:
First Name:SAMY
Middle Name:RAFIK
Last Name:KASHLAN
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 1:2300 PEACHFORD RD
Mailing Address - Street 2:SUITE 1311
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-5820
Mailing Address - Country:US
Mailing Address - Phone:404-368-6568
Mailing Address - Fax:
Practice Address - Street 1:2300 PEACHFORD RD
Practice Address - Street 2:SUITE 1311
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-5820
Practice Address - Country:US
Practice Address - Phone:404-368-6568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program