Basic Information
| Provider Information | |||||||||
| NPI: | 1962848671 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOOSI | ||||||||
| FirstName: | SIAVASH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1010 AIRPARK CENTER DR | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372175200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152214400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1901 PHOENIX BLVD | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303495063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7779941362 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2013 | ||||||||
| LastUpdateDate: | 01/12/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZD0900X | 85044 | GA | N | Allopathic & Osteopathic Physicians | Pathology | Dermatopathology | 207ZD0900X | 59596 | MN | N | Allopathic & Osteopathic Physicians | Pathology | Dermatopathology | 207ND0900X | 85044 | GA | Y | Allopathic & Osteopathic Physicians | Dermatology | Dermatopathology |
No ID Information.