Provider Demographics
NPI:1477381648
Name:PEACHTREE ENDOCRINOLOGY
Entity type:Organization
Organization Name:PEACHTREE ENDOCRINOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER/ENDOCRINOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD FAISAL
Authorized Official - Middle Name:KHAN
Authorized Official - Last Name:SIDDIQUI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:470-913-7350
Mailing Address - Street 1:307 PEPPERMILL LN
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-3111
Mailing Address - Country:US
Mailing Address - Phone:470-913-7350
Mailing Address - Fax:
Practice Address - Street 1:11660 ALPHARETTA HWY STE 600
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-3891
Practice Address - Country:US
Practice Address - Phone:470-913-7350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty