Provider Demographics
NPI:1255650941
Name:DAWOUD
Entity Type:Organization
Organization Name:DAWOUD
Other - Org Name:NORTH GEORGIA URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SINAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HADDAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-776-0493
Mailing Address - Street 1:1630 PLEASANT HILL RD
Mailing Address - Street 2:STE 340
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30136
Mailing Address - Country:US
Mailing Address - Phone:678-776-0493
Mailing Address - Fax:
Practice Address - Street 1:1630 PLEASANT HILL RD
Practice Address - Street 2:STE 340
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30136-5899
Practice Address - Country:US
Practice Address - Phone:678-776-0493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-20
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056455207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA839618790AMedicaid
GA08CBBMQMedicare UPIN