1457797938 NPI number — PERFECT HEALTH ALWAYS ON CALL, LLC

Table of content: ZUBAIR AHMED SYED MD (NPI 1881645216)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457797938 NPI number — PERFECT HEALTH ALWAYS ON CALL, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PERFECT HEALTH ALWAYS ON CALL, LLC
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:
1457797938
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/03/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 509
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GROVETOWN
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30813
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-760-7607
Provider Business Mailing Address Fax Number:
706-760-7605

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4244 WASHINGTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EVANS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30809
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-760-7607
Provider Business Practice Location Address Fax Number:
706-760-7605
Provider Enumeration Date:
05/11/2013

Additional Information

Authorized Official

Authorized Official Last Name:
COON
Authorized Official First Name:
TROY
Authorized Official Middle Name:
PAUL
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
762-218-3627

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X , with the licence number:  056422 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332900000X , with the licence number: 056422 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 202G706320 . This is a "MEDICARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 003164473A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




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