Provider Demographics
NPI:1932549433
Name:SHAHSAVARI, DARIUSH (MD)
Entity Type:Individual
Prefix:DR
First Name:DARIUSH
Middle Name:
Last Name:SHAHSAVARI
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 1:1416 FELDSPAR CT
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-0079
Mailing Address - Country:US
Mailing Address - Phone:443-214-4661
Mailing Address - Fax:
Practice Address - Street 1:1364 CLIFTON RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-5103
Practice Address - Country:US
Practice Address - Phone:404-712-2000
Practice Address - Fax:215-707-0943
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-28
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD458254207R00000X
GA89029207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine