Provider Demographics
NPI:1093046617
Name:FARUQI, AYESHA AFSAR
Entity Type:Individual
Prefix:
First Name:AYESHA
Middle Name:AFSAR
Last Name:FARUQI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 NEWNAN CROSSING BLVD E
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2408
Mailing Address - Country:US
Mailing Address - Phone:770-400-7700
Mailing Address - Fax:770-254-6109
Practice Address - Street 1:2401 NEWNAN CROSSING BLVD E
Practice Address - Street 2:SUITE 200
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2408
Practice Address - Country:US
Practice Address - Phone:770-400-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA070379207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine