Basic Information
Provider Information
NPI: 1205326410
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WAQAR
FirstName: MOHAMMED
MiddleName: FAIZAN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 531 ROSELANE ST NW STE 830
Address2:  
City: MARIETTA
State: GA
PostalCode: 300606979
CountryCode: US
TelephoneNumber: 7707940477
FaxNumber:  
Practice Location
Address1: 531 ROSELANE ST NW STE 830
Address2:  
City: MARIETTA
State: GA
PostalCode: 300606979
CountryCode: US
TelephoneNumber: 7707940477
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/14/2018
LastUpdateDate: 07/07/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/07/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X92743GAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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