Provider Demographics
NPI:1184673238
Name:AGHA, AMR A (MD)
Entity Type:Individual
Prefix:DR
First Name:AMR
Middle Name:A
Last Name:AGHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4904 TIMBER RIDGE DR
Mailing Address - Street 2:SUITE101
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1828
Mailing Address - Country:US
Mailing Address - Phone:770-739-7546
Mailing Address - Fax:770-739-7920
Practice Address - Street 1:4904 TIMBER RIDGE DR
Practice Address - Street 2:SUITE101
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135
Practice Address - Country:US
Practice Address - Phone:770-739-7546
Practice Address - Fax:770-739-7920
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA037741174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist