Provider Demographics
NPI:1821245663
Name:SAWAYA, FADI
Entity Type:Individual
Prefix:
First Name:FADI
Middle Name:
Last Name:SAWAYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 LAVISTA RD NE
Mailing Address - Street 2:APPTT 1243
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-3716
Mailing Address - Country:US
Mailing Address - Phone:404-287-7780
Mailing Address - Fax:
Practice Address - Street 1:69 JESSE HILL JR DR SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3033
Practice Address - Country:US
Practice Address - Phone:404-616-7028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-23
Last Update Date:2008-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program