Provider Demographics
NPI:1619411188
Name:INTEGRATED HEALTH SERVICES OF GEORGIA LLC
Entity Type:Organization
Organization Name:INTEGRATED HEALTH SERVICES OF GEORGIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SALMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BASEER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-906-6164
Mailing Address - Street 1:2251 ROSWELL RD STE 420
Mailing Address - Street 2:1ST FLOOR C&D
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-2974
Mailing Address - Country:US
Mailing Address - Phone:770-906-6164
Mailing Address - Fax:
Practice Address - Street 1:2251 ROSWELL RD STE 420
Practice Address - Street 2:1ST FLOOR C&D
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-2974
Practice Address - Country:US
Practice Address - Phone:770-906-6164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-18
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA591212084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Single Specialty