Provider Demographics
NPI:1962496893
Name:ABBASI, MUHAMMAD (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:
Last Name:ABBASI
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 1:1775 ACCESS RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-1987
Mailing Address - Country:US
Mailing Address - Phone:770-255-0123
Mailing Address - Fax:770-255-0125
Practice Address - Street 1:1775 ACCESS RD
Practice Address - Street 2:SUITE C
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-1987
Practice Address - Country:US
Practice Address - Phone:770-255-0123
Practice Address - Fax:770-255-0125
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA043834207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA11BDSKJMedicare ID - Type Unspecified
GAG55672Medicare UPIN