Provider Demographics
NPI:1033879119
Name:NADER C. GHAZAL MD LLC
Entity Type:Organization
Organization Name:NADER C. GHAZAL MD LLC
Other - Org Name:SUWANEE ORHOPEDIC CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NADER
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAZAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:470-266-1522
Mailing Address - Street 1:4732 TERQUAY CT
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-7523
Mailing Address - Country:US
Mailing Address - Phone:201-280-6423
Mailing Address - Fax:
Practice Address - Street 1:1500 PEACHTREE INDUSTRIAL BLVD STE 220
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-8489
Practice Address - Country:US
Practice Address - Phone:470-266-1522
Practice Address - Fax:470-266-1455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-30
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty