Provider Demographics
NPI:1467614438
Name:ALI, SADIA MAHMOOD (DPM)
Entity Type:Individual
Prefix:DR
First Name:SADIA
Middle Name:MAHMOOD
Last Name:ALI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:SADIA
Other - Middle Name:
Other - Last Name:MAHMOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:900 CIRCLE 75 PKWY SE STE 900
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3084
Mailing Address - Country:US
Mailing Address - Phone:678-426-2171
Mailing Address - Fax:404-446-1957
Practice Address - Street 1:100 GREYSTONE POWER BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157-0908
Practice Address - Country:US
Practice Address - Phone:709-437-8777
Practice Address - Fax:770-943-8809
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005506213ES0103X
FL135213ES0103X
GAPOD001220213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery