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Search › Georgia › 363A00000X

Shayan Bagheri, PA-C

NPI 1205678554 · on the registry since 2024 · sole proprietor

Practice

Address
204 Canton Rd
Cumming, GA 30040
Phone
(770) 886-5437
Organisation at this address
Lakeside Pediatrics, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
4

Registry record

Primary taxonomy
363A00000X
363A00000X
Also registered as
363AM0700X
Licence states on file
GA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2024-06-18

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia