Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | DNF000254 | GA |
NPI | 1902854110 |
---|---|
Provider Name | Dr. Rafik Albert Abdelsayed |
First Address | Augusta, GA 30912-0001 |
Second Address | Augusta, GA 30912-1001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 22/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00775222A | (05) | GA |
U66554 | (02) | GA |
ZG0254 | (05) | SC |