Provider Demographics
NPI:1053134486
Name:SAEF, DAVID KENNETH (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:KENNETH
Last Name:SAEF
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4051 JORDAN LAKE DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-5785
Mailing Address - Country:US
Mailing Address - Phone:770-750-2658
Mailing Address - Fax:
Practice Address - Street 1:4051 JORDAN LAKE DR
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-5785
Practice Address - Country:US
Practice Address - Phone:770-750-2658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH014224183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist