1346466612 NPI number — DR. MOHAMMED NAZMUL HUQ D.D.S

Table of content: DR. MOHAMMED NAZMUL HUQ D.D.S (NPI 1346466612)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346466612 NPI number — DR. MOHAMMED NAZMUL HUQ D.D.S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUQ
Provider First Name:
MOHAMMED
Provider Middle Name:
NAZMUL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.D.S
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346466612
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2106 BRODICK LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITHIA SPRINGS
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30122-6892
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-933-3592
Provider Business Mailing Address Fax Number:
770-732-9778

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3383 VETERANS MEMORIAL HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LITHIA SPRINGS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30122-1450
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-732-9222
Provider Business Practice Location Address Fax Number:
770-732-9778
Provider Enumeration Date:
04/17/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  DN012722 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)