Provider Demographics
NPI:1861837486
Name:DAYA, SULEMAN
Entity Type:Individual
Prefix:
First Name:SULEMAN
Middle Name:
Last Name:DAYA
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 1:926 MONTREAL RD STE 2
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30021-1399
Mailing Address - Country:US
Mailing Address - Phone:404-299-8255
Mailing Address - Fax:404-299-8219
Practice Address - Street 1:926 MONTREAL RD STE 2
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:GA
Practice Address - Zip Code:30021-1399
Practice Address - Country:US
Practice Address - Phone:404-299-8255
Practice Address - Fax:404-299-8219
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH018971183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist