Provider Demographics
NPI:1417584491
Name:SIDANI, REEM M (MD)
Entity Type:Individual
Prefix:
First Name:REEM
Middle Name:M
Last Name:SIDANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3333 RIVERWOOD PKWY SE STE 250
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3304
Mailing Address - Country:US
Mailing Address - Phone:770-914-0116
Mailing Address - Fax:
Practice Address - Street 1:211 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:ELLENWOOD
Practice Address - State:GA
Practice Address - Zip Code:30294-2721
Practice Address - Country:US
Practice Address - Phone:678-289-6747
Practice Address - Fax:678-289-6750
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA97088207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine