Provider Demographics
NPI:1790899169
Name:NAJJAR, OMAR (MD)
Entity Type:Individual
Prefix:
First Name:OMAR
Middle Name:
Last Name:NAJJAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 934915
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-4915
Mailing Address - Country:US
Mailing Address - Phone:404-501-7969
Mailing Address - Fax:404-501-3874
Practice Address - Street 1:2675 N DECATUR RD
Practice Address - Street 2:STE 601
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6131
Practice Address - Country:US
Practice Address - Phone:404-501-2900
Practice Address - Fax:404-501-2992
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA21771207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D30319Medicare UPIN
GA08BDHNMMedicare ID - Type Unspecified