Provider Demographics
NPI:1083062764
Name:NAVA, AISBEL (MD)
Entity Type:Individual
Prefix:MRS
First Name:AISBEL
Middle Name:
Last Name:NAVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PERIMETER SUMMIT BLVD NE APT 2110
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-1480
Mailing Address - Country:US
Mailing Address - Phone:404-663-9319
Mailing Address - Fax:
Practice Address - Street 1:10 PERIMETER SUMMIT BLVD NE APT 2110
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-1480
Practice Address - Country:US
Practice Address - Phone:404-663-9319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA16-332246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant