Provider Demographics
NPI:1376650333
Name:ARSHAD, MOHAMMAD (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:
Last Name:ARSHAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:MOHAMMAD
Other - Middle Name:
Other - Last Name:ARSHAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:871 FOREST PKWY
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30297-2381
Mailing Address - Country:US
Mailing Address - Phone:404-363-9581
Mailing Address - Fax:404-363-0743
Practice Address - Street 1:871 FOREST PKWY
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:GA
Practice Address - Zip Code:30297-2381
Practice Address - Country:US
Practice Address - Phone:404-363-9581
Practice Address - Fax:404-363-0743
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA020511174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00636721AMedicaid
GA00636721AMedicaid