Provider Demographics
NPI:1023066206
Name:SOLIMAN, NOHA RAOUF
Entity type:Individual
Prefix:
First Name:NOHA
Middle Name:RAOUF
Last Name:SOLIMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 E US HIGHWAY 80 STE D
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:GA
Mailing Address - Zip Code:31302-9356
Mailing Address - Country:US
Mailing Address - Phone:912-999-7275
Mailing Address - Fax:
Practice Address - Street 1:502 E US HIGHWAY 80 STE D
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:GA
Practice Address - Zip Code:31302-9356
Practice Address - Country:US
Practice Address - Phone:912-999-7275
Practice Address - Fax:912-988-3748
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA077788207R00000X, 207R00000X
MI5501010909225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIQ47497Medicare UPIN
MIN93670024Medicare ID - Type Unspecified