1831443936 NPI number — GEORGIA COLLEGE & STATE UNIVERSITY

Table of content: SHEREEN K. ALIKHAN M.D. (NPI 1982950259)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831443936 NPI number — GEORGIA COLLEGE & STATE UNIVERSITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GEORGIA COLLEGE & STATE UNIVERSITY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1831443936
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
120 W CAMPUS DR
Provider Second Line Business Mailing Address:
CBX 091
Provider Business Mailing Address City Name:
MILLEDGEVILLE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31061-1990
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
478-445-5288
Provider Business Mailing Address Fax Number:
478-445-3142

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 W CAMPUS DR
Provider Second Line Business Practice Location Address:
CBX 091
Provider Business Practice Location Address City Name:
MILLEDGEVILLE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31061-1990
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
478-445-5288
Provider Business Practice Location Address Fax Number:
478-445-3142
Provider Enumeration Date:
10/29/2012

Additional Information

Authorized Official

Authorized Official Last Name:
ALLEN
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
Authorized Official Title or Position:
INTERIM SR VP FOR FINANCE AND ADMIN
Authorized Official Telephone Number:
478-445-5148

Provider Taxonomy Codes

  • Taxonomy code: 261QS1000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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