Provider Demographics
NPI:1598938706
Name:SYED, AAZRUM IMRAN (MD)
Entity Type:Individual
Prefix:
First Name:AAZRUM
Middle Name:IMRAN
Last Name:SYED
Suffix:
Gender:F
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 1103
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-7974
Mailing Address - Country:US
Mailing Address - Phone:678-867-0904
Mailing Address - Fax:678-867-0905
Practice Address - Street 1:11820 NORTHFALL LN
Practice Address - Street 2:SUITE 1103
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-7974
Practice Address - Country:US
Practice Address - Phone:678-867-0904
Practice Address - Fax:678-867-0905
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001619207R00000X
GA61759207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine