1629599279 NPI number — HUDA HASHIM ELSAMANI ELSHEIKH MD

Table of content: HUDA HASHIM ELSAMANI ELSHEIKH MD (NPI 1629599279)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629599279 NPI number — HUDA HASHIM ELSAMANI ELSHEIKH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ELSHEIKH
Provider First Name:
HUDA
Provider Middle Name:
HASHIM ELSAMANI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1629599279
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
303 PARKWAY DRIVE NE, WELLSTAR ATLANTA MEDICAL CENTER
Provider Second Line Business Mailing Address:
DEPT OF GRADUATE MEDICAL EDUCATION, INTERNAL MEDICINE
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30312
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-265-4919
Provider Business Mailing Address Fax Number:
404-265-4989

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
303 PARKWAY DR NE, WELLSTAR ATLANTA MEDICAL CENTER
Provider Second Line Business Practice Location Address:
DEPT OF GRADUATE MEDICAL EDUCATION, INTERNAL MEDICINE
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-265-4919
Provider Business Practice Location Address Fax Number:
404-265-4989
Provider Enumeration Date:
07/05/2017

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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