Provider Demographics
NPI:1386655223
Name:MASUD, TAHSIN (MD)
Entity Type:Individual
Prefix:
First Name:TAHSIN
Middle Name:
Last Name:MASUD
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 1:550 PEACHTREE ST NE FL 7
Mailing Address - Street 2:EMORY CRAWFORD LONG MOT - NEPHROLOGY
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2247
Mailing Address - Country:US
Mailing Address - Phone:404-686-5038
Mailing Address - Fax:
Practice Address - Street 1:550 PEACHTREE ST NE FL 7
Practice Address - Street 2:EMORY CRAWFORD LONG MOT - NEPHROLOGY
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2247
Practice Address - Country:US
Practice Address - Phone:404-686-5038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031174207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE60732Medicare UPIN