Provider Demographics
NPI:1356972848
Name:NORTH ATLANTA PLASTIC SURGERY GROUP LLC
Entity type:Organization
Organization Name:NORTH ATLANTA PLASTIC SURGERY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PLASTIC RECONSTRUCTIVE SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABOLMAALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-781-9094
Mailing Address - Street 1:11877 DOUGLAS RD STE 102-367
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4325
Mailing Address - Country:US
Mailing Address - Phone:470-451-9725
Mailing Address - Fax:
Practice Address - Street 1:11877 DOUGLAS RD STE 102-367
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30005-4325
Practice Address - Country:US
Practice Address - Phone:470-451-9725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty