Provider Demographics
NPI:1932294493
Name:SYED, RIAZ ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:RIAZ
Middle Name:ALI
Last Name:SYED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:870 COLLINS HILL RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043
Mailing Address - Country:US
Mailing Address - Phone:678-377-0900
Mailing Address - Fax:678-377-6556
Practice Address - Street 1:870 COLLINS HILL RD
Practice Address - Street 2:PRIMARY CARE CENTER OF GEORGIA, INC
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043
Practice Address - Country:US
Practice Address - Phone:678-377-0900
Practice Address - Fax:678-377-6556
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-03-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA043791207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000752507AMedicaid
GA11BDMJZMedicare ID - Type Unspecified
GAF95099Medicare UPIN