Provider Demographics
NPI:1518079136
Name:SYED, IMRAN (MD)
Entity Type:Individual
Prefix:DR
First Name:IMRAN
Middle Name:
Last Name:SYED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11820 NORTHFALL LN
Mailing Address - Street 2:SUITE 1101
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-7974
Mailing Address - Country:US
Mailing Address - Phone:770-777-1359
Mailing Address - Fax:770-777-1368
Practice Address - Street 1:11820 NORTHFALL LN
Practice Address - Street 2:SUITE 1101
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-7974
Practice Address - Country:US
Practice Address - Phone:770-777-1359
Practice Address - Fax:770-777-1368
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2010-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044117207RE0101X
GA44117207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG54999Medicare UPIN
GA11BDWXJMedicare ID - Type Unspecified