Difrakhsh, Mike Mehrdad
Difrakhsh, Mike Mehrdad is an sole proprietor health care provider with primary practice located at 105 Sable Pointe Dr , Alpharetta GA 30004-2773. He recently has 4 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Geriatrics, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is his primary health care specialty. Difrakhsh, Mike Mehrdad can be contacted via phone (678) 983-5304.Contact Information
Primary practice address
105 Sable Pointe Dr
Alpharetta GA 30004-2773
Phone: (678) 983-5304
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT007856 | Georgia |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Geriatrics | 2251G0304X | PT007856 | Georgia |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 2251P0200X | PT007856 | Georgia |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports | 2251S0007X | PT007856 | Georgia |
Profile Details
| NPI number | 1689776379 |
|---|---|
| LBN Legal business name | Difrakhsh, Mike Mehrdad |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 2nd, 2006 |
| Last updated | May 24th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689776379 | NPPES |
| Georgia | MEDICAID | 798679179C |
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