Provider Demographics
NPI:1346376621
Name:HAJMURAD, M. RAMZY SALEH (MD)
Entity Type:Individual
Prefix:DR
First Name:M. RAMZY
Middle Name:SALEH
Last Name:HAJMURAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 MULKEY RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1151
Mailing Address - Country:US
Mailing Address - Phone:770-941-8508
Mailing Address - Fax:770-941-8542
Practice Address - Street 1:1810 MULKEY RD
Practice Address - Street 2:SUITE 205
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1151
Practice Address - Country:US
Practice Address - Phone:770-941-8508
Practice Address - Fax:770-941-8542
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA021704174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00202748AMedicaid
GAD99638Medicare UPIN