Provider Demographics
NPI:1396929873
Name:ABDULBAAQEE, NAILAH (MD)
Entity type:Individual
Prefix:
First Name:NAILAH
Middle Name:
Last Name:ABDULBAAQEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 HOLCOMB BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-4703
Mailing Address - Country:US
Mailing Address - Phone:404-855-2242
Mailing Address - Fax:404-793-6727
Practice Address - Street 1:950 BATTERY AVE SE STE 1216
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-3094
Practice Address - Country:US
Practice Address - Phone:888-663-6331
Practice Address - Fax:415-252-7176
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA063829207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA164265469AMedicaid
GA202I089821Medicare PIN