Provider Demographics
NPI:1598860298
Name:NASSERY, HOGAI G (MD)
Entity Type:Individual
Prefix:
First Name:HOGAI
Middle Name:G
Last Name:NASSERY
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:10 PARK PLACE SOUTH SE # 445
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-2913
Mailing Address - Country:US
Mailing Address - Phone:404-613-1242
Mailing Address - Fax:404-612-2285
Practice Address - Street 1:10 PARK PLACE SOUTH SE # 445
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-2913
Practice Address - Country:US
Practice Address - Phone:404-613-1242
Practice Address - Fax:404-612-2285
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2017-11-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA43718207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG54540Medicare UPIN