Provider Demographics
NPI:1437470549
Name:DHABAAN, ESRAA F (MD)
Entity Type:Individual
Prefix:DR
First Name:ESRAA
Middle Name:F
Last Name:DHABAAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:290 COUNTRY CLUB DR
Mailing Address - Street 2:SUITE220
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-9069
Mailing Address - Country:US
Mailing Address - Phone:678-284-6300
Mailing Address - Fax:678-284-6336
Practice Address - Street 1:259 JONESBORO RD
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-3769
Practice Address - Country:US
Practice Address - Phone:770-957-8666
Practice Address - Fax:770-957-0375
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-13
Last Update Date:2015-03-16
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Provider Licenses
StateLicense IDTaxonomies
GA070368363A00000X, 207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program