Provider Demographics
NPI:1508373473
Name:ORAMAS, ELIEZER
Entity Type:Individual
Prefix:
First Name:ELIEZER
Middle Name:
Last Name:ORAMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1281 PINE ACRE DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-6716
Mailing Address - Country:US
Mailing Address - Phone:678-292-3965
Mailing Address - Fax:
Practice Address - Street 1:270 CARPENTER DR STE 400
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4933
Practice Address - Country:US
Practice Address - Phone:678-460-0345
Practice Address - Fax:678-460-0350
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-02
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA056603278Medicaid