Provider Demographics
NPI:1629288873
Name:ASAF ALEEM, M.D. PC
Entity Type:Organization
Organization Name:ASAF ALEEM, M.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-454-1252
Mailing Address - Street 1:2150 PEACHFORD RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6520
Mailing Address - Country:US
Mailing Address - Phone:770-454-1252
Mailing Address - Fax:770-454-1256
Practice Address - Street 1:2150 PEACHFORD RD
Practice Address - Street 2:SUITE H
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-6520
Practice Address - Country:US
Practice Address - Phone:770-454-1252
Practice Address - Fax:770-454-1256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0302602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAA76519Medicare UPIN