Provider Demographics
NPI:1720252240
Name:HAQUE, NABILA ZAFAR
Entity Type:Individual
Prefix:
First Name:NABILA
Middle Name:ZAFAR
Last Name:HAQUE
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 1:10712 GLENLEIGH DR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-8071
Mailing Address - Country:US
Mailing Address - Phone:678-642-8883
Mailing Address - Fax:
Practice Address - Street 1:5905 STEWART PKWY
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135
Practice Address - Country:US
Practice Address - Phone:770-949-8082
Practice Address - Fax:770-739-8916
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0019912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry