Provider Demographics
NPI:1437432358
Name:GA HIGHLANDS OB/GYN, PC
Entity Type:Organization
Organization Name:GA HIGHLANDS OB/GYN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FAREED
Authorized Official - Middle Name:Z
Authorized Official - Last Name:KADUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-334-8818
Mailing Address - Street 1:962 JOE FRANK HARRIS PKWY,
Mailing Address - Street 2:STE 202
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-2142
Mailing Address - Country:US
Mailing Address - Phone:770-334-8818
Mailing Address - Fax:770-334-8819
Practice Address - Street 1:962 JOE FRANK HARRIS PKWY,
Practice Address - Street 2:STE 202
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-2142
Practice Address - Country:US
Practice Address - Phone:770-334-8818
Practice Address - Fax:770-334-8819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-27
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA022993207V00000X
207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1760495840OtherNPI FAREED Z. KADUM, MD
GA000262556DMedicaid