Basic Information
| Provider Information | |||||||||
| NPI: | 1003008566 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAFRAN | ||||||||
| FirstName: | MARC | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 CLIFTON RD NE | ||||||||
| Address2: | TO: CAPT MARC SAFRAN, US PUBLIC HEALTH SERVICE, CDC | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303294018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4046393311 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1600 CLIFTON RD NE | ||||||||
| Address2: | TO: CAPT MARC SAFRAN, US PUBLIC HEALTH SERVICE, CDC | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303294018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4046393311 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2007 | ||||||||
| LastUpdateDate: | 08/17/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 188223 | NY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.