Provider Demographics
NPI:1801277124
Name:EL, AHMAD
Entity type:Individual
Prefix:
First Name:AHMAD
Middle Name:
Last Name:EL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3461 LAWRENCEVILLE SUWANEE RD STE B
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6428
Mailing Address - Country:US
Mailing Address - Phone:678-526-4286
Mailing Address - Fax:
Practice Address - Street 1:3461 LAWRENCEVILLE SUWANEE RD STE B
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6428
Practice Address - Country:US
Practice Address - Phone:678-526-4286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-11
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA368171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist