MITRA POORAK (NPI# 1881072940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881072940 |
| Entity Type | Individual |
| Full Name | MITRA POORAK |
| Credential | M.D. |
| Practice Address |
1301 Sigman Rd Ne Ste 180 Conyers GA 30012-3924 |
| Mailing Address |
1444 Valley View Rd Atlanta GA 30338-4825 |
| Practice Telephone | 7709224024 |
| Mailing Telephone | 4045161024 |
| Enumeration Date | 2015-05-09 |
| Last Update Date | 2020-09-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 008421 | GA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1120 15th St, Augusta, GA 309120004 | 7067217005 |
| Street Address |
1301 SIGMAN RD NE STE 180 |
| City | CONYERS |
| State | GA |
| Zip Code | 30012-3924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316900343 | Regina C Bogle | Nurse Practitioner | 1301 Sigman Rd Ne Ste 180, Conyers, GA 30012-3924 | 2006-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578188306 | The Eye Md | Ophthalmology | 1359 Milstead Road, Suite #103, Conyers, GA 30012 | 2020-06-08 |
| 1043855836 | Maurvet Minto | Counselor | 1175 Green St, Conyers, Conyers, GA 30012 | 2019-11-15 |
| 1770054561 | Sarah Elizabeth Brooks | Physical Medicine & Rehabilitation | 1290 Milstead Ave Ne, Conyers, GA 30012 | 2018-12-06 |
| 1679091276 | Valorie Antoinette Jones | Counselor | 1175 Green St Se, Conyers, GA 30012 | 2017-09-02 |
| 1558886341 | Synergy Radiology, LLC | Radiology | 1501 Milstead Road, Suite 140, Conyers, GA 30012 | 2017-08-14 |
| 1558813295 | Salon Lyon, LLC | Specialist | 1112 West Ave, Se, B, Conyers, GA 30012 | 2016-10-28 |
| 1992252753 | Traci Hunter Bryan | Pharmacist | 1501 Milstead Ave Ne, Suite 110, Conyers, GA 30012 | 2016-09-08 |
| 1316491830 | Hye Rim Kim | Anesthesiologist Assistant | 1380 Milstead Rd Ne, Suite G, Conyers, GA 30012 | 2016-08-12 |
| 1235591397 | David Jeffrey Wasserman | Optometrist | 1192 Dogwood Dr Sw, Conyers, GA 30012 | 2016-03-28 |
| 1174919187 | Anique Archer | Health Educator | 2170 Lester Rd Nw, Conyers, GA 30012 | 2015-04-07 |
| Find all providers in zip 30012 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669630893 | Tamica E White | Surgery | 1301 Sigman Rd Ne Ste 190, Conyers, GA 30012-3924 | 2008-05-23 |
| 1013046309 | Millard I Ross | Surgery | 2724 Highway 212 Sw, Conyers, GA 30094-3370 | 2007-03-05 |
| 1194772749 | Donald Maynard | Surgery | 1612b Milstead Rd Ne, Conyers, GA 30012-3738 | 2006-05-28 |
| 1134129562 | Andrew S Harper | Surgery | 1364 Wellbrook Cir Ne, Conyers, GA 30012-3872 | 2005-07-28 |
| 1457589186 | Rachael Springer | Surgery | 1301 Sigman Rd Ne Ste 190, Conyers, GA 30012-3924 | 2009-07-01 |
| 1184872723 | Surgical Assoicates of Metro Atlanta, LLC | Surgery | 1612 Milstead Rd Ne, Conyers, GA 30012-3738 | 2008-09-08 |
| 1538339338 | Millard I. Ross, M.d., LLC | Surgery | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2008-03-07 |
| 1457537201 | Kimberly A Singh | Surgery | 1368 Wellbrook Cir Ne, Suite B, Conyers, GA 30012-3949 | 2008-01-10 |
| 1831374453 | Nour Abboushi | Surgery | 1368 Wellbrook Cir Ne, Suite B, Conyers, GA 30012-3949 | 2008-01-02 |
| 1225211071 | Gayla Dillard Md PC | Surgery | 1364 Wellbrook Cir Ne, Conyers, GA 30012-3872 | 2007-12-14 |
| Find all providers in CONYERS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.