Provider Demographics
NPI:1467759837
Name:M. RAMZY HAJMURAD, M. D., P.C.
Entity Type:Organization
Organization Name:M. RAMZY HAJMURAD, M. D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:M. RAMZY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAJMURAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-941-8508
Mailing Address - Street 1:1810 MULKEY RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1151
Mailing Address - Country:US
Mailing Address - Phone:770-941-8508
Mailing Address - Fax:770-941-8542
Practice Address - Street 1:1810 MULKEY RD
Practice Address - Street 2:SUITE 205
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1151
Practice Address - Country:US
Practice Address - Phone:770-941-8508
Practice Address - Fax:770-941-8542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA021704208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00202738AMedicaid
GAD99638Medicare UPIN