Provider Demographics
NPI:1700432267
Name:KARRIEM, AMIRA (MBA, BS, RT)
Entity Type:Individual
Prefix:MRS
First Name:AMIRA
Middle Name:
Last Name:KARRIEM
Suffix:
Gender:F
Credentials:MBA, BS, RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 VALLEY VIEW CIR LOT 59
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132-9806
Mailing Address - Country:US
Mailing Address - Phone:404-861-4087
Mailing Address - Fax:888-545-1070
Practice Address - Street 1:256 VALLEY VIEW CIR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30132-9806
Practice Address - Country:US
Practice Address - Phone:678-903-5786
Practice Address - Fax:888-545-1070
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3262042471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003234554AMedicaid