Provider Demographics
NPI:1033498118
Name:ULLAH, SYED ZIA (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:ZIA
Last Name:ULLAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2137 MERRYMOUNT DR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-3257
Mailing Address - Country:US
Mailing Address - Phone:770-963-1549
Mailing Address - Fax:
Practice Address - Street 1:2536 LAWRENCEVILLE HWY
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3227
Practice Address - Country:US
Practice Address - Phone:770-934-6832
Practice Address - Fax:770-934-6337
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA066732207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine