Provider Demographics
NPI:1114974888
Name:TAMIM, HIBA (MD)
Entity Type:Individual
Prefix:
First Name:HIBA
Middle Name:
Last Name:TAMIM
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 1:1100 JOHNSON FERRY RD NE
Mailing Address - Street 2:SUITE 510
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1709
Mailing Address - Country:US
Mailing Address - Phone:404-419-1140
Mailing Address - Fax:404-419-1164
Practice Address - Street 1:2545 LAWRENCEVILLE HWY
Practice Address - Street 2:SUITE 300
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3239
Practice Address - Country:US
Practice Address - Phone:404-321-1950
Practice Address - Fax:404-633-9838
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA038156207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00705988BMedicaid
GA00705988BMedicaid
GA83BBBQLMedicare ID - Type Unspecified