Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 045011 | GA |
NPI | 1053399626 |
---|---|
Provider Name | Dr. Alaa El-Din Soltan |
First Address | Atlanta, GA 30341-1072 |
Second Address | Austell, GA 30106-1143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2006 |
Last Update Date | 14/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000781657AC | (05) | GA |
000781657AD | (05) | GA |
CA9328 | MEDICARE GROUP-DMERC (01) | GA |
F75199 | (02) | GA |