Provider Demographics
NPI:1770895419
Name:SYED, FAHD KHALID (MD)
Entity type:Individual
Prefix:DR
First Name:FAHD
Middle Name:KHALID
Last Name:SYED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2032 WYNNTON RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906-2448
Mailing Address - Country:US
Mailing Address - Phone:706-322-8820
Mailing Address - Fax:706-322-8850
Practice Address - Street 1:2032 WYNNTON RD
Practice Address - Street 2:SUITE A
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-2448
Practice Address - Country:US
Practice Address - Phone:706-322-8820
Practice Address - Fax:706-322-8850
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA243920207R00000X
GA72823207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003154272AMedicaid