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1972021962
OMID MIDANAKY
DECATUR, GA
NPI
1972021962
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2017-08-30
Last Update Date
2017-08-30
Business Address
OMID MIDANAKY PA-C
2801 N DECATUR RD
DECATUR, GA 30033-5949
Phone number: 404-296-5055
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Mailing Address
OMID MIDANAKY PA-C
810 WHISPERWOOD TRL
ACWORTH, GA 30102-7586
Phone number: 404-704-2813
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