Provider Demographics
NPI:1639338031
Name:EAST METRO OB GYN SPECIALISTS INC
Entity Type:Organization
Organization Name:EAST METRO OB GYN SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACOG
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:EL-ATTAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-483-2368
Mailing Address - Street 1:1311 MILSTEAD AVE NE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-3829
Mailing Address - Country:US
Mailing Address - Phone:770-483-2368
Mailing Address - Fax:770-785-5080
Practice Address - Street 1:4106 MILL ST NE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2539
Practice Address - Country:US
Practice Address - Phone:770-786-8955
Practice Address - Fax:770-785-5080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA00001733174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP1880Medicare PIN