Provider Demographics
NPI:1568894434
Name:AHMED, MIRA ABDURASHID (DC)
Entity Type:Individual
Prefix:
First Name:MIRA
Middle Name:ABDURASHID
Last Name:AHMED
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 DEKALB INDUSTRIAL WAY
Mailing Address - Street 2:STE 105
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1756
Mailing Address - Country:US
Mailing Address - Phone:404-500-4881
Mailing Address - Fax:404-500-4897
Practice Address - Street 1:575 DEKALB INDUSTRIAL WAY
Practice Address - Street 2:STE 105
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1756
Practice Address - Country:US
Practice Address - Phone:404-500-4881
Practice Address - Fax:404-500-4897
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008996111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor