Provider Demographics
NPI:1053128686
Name:ASADZADEH, AMIR
Entity type:Individual
Prefix:
First Name:AMIR
Middle Name:
Last Name:ASADZADEH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1252 EDENBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-7089
Mailing Address - Country:US
Mailing Address - Phone:404-451-4863
Mailing Address - Fax:
Practice Address - Street 1:3855 HOLCOMB BRIDGE RD STE 200
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-5249
Practice Address - Country:US
Practice Address - Phone:678-667-0095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health