Provider Demographics
NPI:1790071926
Name:BABER, SYED RIAZUDDIN (MD, PHD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:RIAZUDDIN
Last Name:BABER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4161 STEVE REYNOLDS BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-3060
Mailing Address - Country:US
Mailing Address - Phone:678-380-8353
Mailing Address - Fax:678-380-8388
Practice Address - Street 1:4161 STEVE REYNOLDS BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-3060
Practice Address - Country:US
Practice Address - Phone:678-380-8353
Practice Address - Fax:678-380-8388
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0050803208D00000X
GA005083207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine