Provider Demographics
NPI:1093136681
Name:MIDDLE GEORGIA HEART RHYTHM SPECIALISTS, LLC
Entity Type:Organization
Organization Name:MIDDLE GEORGIA HEART RHYTHM SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-773-9302
Mailing Address - Street 1:427 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-3335
Mailing Address - Country:US
Mailing Address - Phone:478-238-4588
Mailing Address - Fax:478-238-4599
Practice Address - Street 1:427 POPLAR ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-3335
Practice Address - Country:US
Practice Address - Phone:478-238-4588
Practice Address - Fax:478-238-4599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-26
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA67918207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1710996194Medicare UPIN
TX8C6863Medicare PIN