Provider Demographics
NPI:1740569565
Name:AL-BALDAWI, RUAA NABIL (PHARMD)
Entity Type:Individual
Prefix:
First Name:RUAA
Middle Name:NABIL
Last Name:AL-BALDAWI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PERIMETER CENTER PL NE
Mailing Address - Street 2:TARGET 2036
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30346-1204
Mailing Address - Country:US
Mailing Address - Phone:678-259-0889
Mailing Address - Fax:678-259-0889
Practice Address - Street 1:100 PERIMETER CENTER PL NE
Practice Address - Street 2:TARGET 2036
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30346-1204
Practice Address - Country:US
Practice Address - Phone:678-259-0889
Practice Address - Fax:678-259-0889
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH024872183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist