Provider Demographics
NPI:1093081416
Name:AESTHETICS INTERNATIONAL USA
Entity Type:Organization
Organization Name:AESTHETICS INTERNATIONAL USA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HUSAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-805-2821
Mailing Address - Street 1:3910 OVERLAKE DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-2845
Mailing Address - Country:US
Mailing Address - Phone:561-283-5131
Mailing Address - Fax:
Practice Address - Street 1:59 TIPTON DR
Practice Address - Street 2:
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533-1603
Practice Address - Country:US
Practice Address - Phone:706-867-0637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA051423208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA251265615CMedicaid