Javad Deganian, MD
Pediatrics in Snellville, GA. Individual provider (NPI-1).
NPI number1366491235
StatusActive
Last updated in NPPESAug 11, 2011
Details
- NPI
- 1366491235
- Entity type
- Individual (NPI-1)
- Name
- Javad Deganian
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 9, 2006
- Last updated
- Aug 11, 2011
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | 016053 | GA | Yes |
Practice location
1700 Tree Lane RdSte 110
Snellville, GA 30078
Phone 770-972-0860 · Fax 770-972-0850
Mailing address
1700 Tree Lane RdSte 110
Snellville, GA 30078
Phone 770-972-0860 · Fax 770-972-0850
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