Provider Demographics
NPI:1306823455
Name:S.Y.A.H.
Entity Type:Organization
Organization Name:S.Y.A.H.
Other - Org Name:GUILFORD IMMEDIATE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AYHAM
Authorized Official - Middle Name:YOUSEF
Authorized Official - Last Name:HADDAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-532-0800
Mailing Address - Street 1:1250 JESSE JEWEL PKWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3871
Mailing Address - Country:US
Mailing Address - Phone:770-532-0800
Mailing Address - Fax:770-532-0801
Practice Address - Street 1:1250 JESSE JEWELL PKWY SE
Practice Address - Street 2:SUITE 400
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3871
Practice Address - Country:US
Practice Address - Phone:770-532-0800
Practice Address - Fax:770-532-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-29
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP7705Medicare PIN